| 李胜.腭咽成形术联合咽腔与颏舌肌锻炼对睡眠呼吸暂停综合征临床疗效及对NF-kB、TNF-α、睡眠结构的影响[J].浙江中西医结合杂志,2026,36(1): |
| 腭咽成形术联合咽腔与颏舌肌锻炼对睡眠呼吸暂停综合征临床疗效及对NF-kB、TNF-α、睡眠结构的影响 |
| The clinical efficacy of uvulopalatopharyngoplasty combined with pharyngeal cavity and genioglossus muscle exercise on obstructive sleep apnea hypopnea syndrome and its effects on NF-kB, TNF-α, and sleep structure |
| 投稿时间：2024-09-19 修订日期：2025-11-05 |
| DOI： |
| 中文关键词: 颏舌肌锻炼 腭咽成形术 睡眠呼吸暂停综合征 睡眠结构 肿瘤坏死因子-α 核转录因子-kB |
| 英文关键词:Pharyngeal cavity and genioglossus muscle exercise Uvulopalatopharyngoplasty Obstructivesleepapnea hypopneasyndrome Sleep structure Tumor necrosis factor-α Nuclear transcription factor-kB |
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| 中文摘要: |
| 目的:探讨腭咽成形术联合咽腔与颏舌肌锻炼对睡眠呼吸暂停综合征(OSAHS)临床疗效及对肿瘤坏死因子-α(TNF-α)、核转录因子-kB(NF-kB)、睡眠结构的影响。方法:选取本院耳鼻咽喉科2021年3月~2023年10月收治的86例OSAH患者,随机分为对照组和观察组,各43例。两组均实施改良悬雍垂腭咽成形术治疗,另观察组在术后接受咽腔与颏舌肌锻炼,连续锻炼6个月。比较两组治疗前和治疗6个月后的睡眠结构、睡眠质量、生活质量及炎症指标,并评价临床疗效。结果:研究期间,86例受试者共剔除7例(对照组剔除2例,观察组剔除5例)。治疗6个月后,观察组相较于对照组总有效率更高(P＜0.05)。治疗6个月后,观察组和对照组快速眼动睡眠(REM)期及Ⅲ期+Ⅳ期占比均升高,Ⅰ期+Ⅱ期占比及每小时睡眠中呼吸暂停与低通气的数目总和(AHI)均降低(P＜0.05)；且治疗6个月后,观察组相较于对照组REM期及Ⅲ期+Ⅳ期占比均更高,Ⅰ期+Ⅱ期占比及AHI均更低(P＜0.05)。治疗6个月后,观察组和对照组匹兹堡睡眠质量指数(PSQI)评分均降低,Calgary睡眠呼吸暂停生活质量指数(SAQLI)评分均升高(P＜0.05)；且治疗6个月后,观察组相较于对照组PSQI评分更低,SAQLI评分更高(P＜0.05)。两组治疗6个月后,观察组和对照组血清TNF-α、NF-kB水平均降低(P＜0.05)；且治疗6个月后,观察组相较于对照组血清TNF-α、NF-kB水平均更低(P＜0.05)。结论:腭咽成形术联合咽腔与颏舌肌锻炼能够提高OSAHS治疗效果,调节炎症反应,改善睡眠结构、睡眠质量及生活质量。 |
| 英文摘要: |
| Objective: To investigate the clinical efficacy of uvulopalatopharyngoplasty combined with pharyngeal cavity and genioglossus muscle exercise in obstructive sleep apnea hypopnea syndrome (OSAHS) and its effects on tumor necrosis factor-α (TNF-α), nuclear transcription factor-kB (NF-kB), and sleep structure. Methods: 86 OSAH patients admitted to the Otolaryngology Department of our hospital from March 2021 to October 2023 were randomly divided into a control group and an observation group, with 43 patients in each group. Both groups underwent modified uvulopalatopharyngoplasty, while the observation group received pharyngeal cavity and genioglossus muscle exercises for 6 months after surgery. The sleep structure, sleep quality, quality of life, and inflammatory indicators between two groups before and after 6 months of treatment were compared, and the clinical efficacy of the two groups was evaluated. Results: During the study period, a total of 7 out of 86 subjects were excluded (2 out of the control group and 5 out of the observation group). After 6 months of treatment, the observation group had a higher overall effective rate compared to the control group(P＜0.05). After 6 months of treatment, both groups showed an increase in the proportion of rapid eye movement sleep (REM) phase and phase III+IV, while the proportion of phase I+II and the total number of apnea and hypopnea per hour of sleep (AHI) decreased(P＜0.05). After 6 months of treatment, the observation group had a higher proportion of REM and III+IV phases compared to the control group, while the proportion of I+II phases and AHI were lower(P＜0.05). After 6 months of treatment, both groups showed a decrease in Pittsburgh Sleep Quality Index (PSQI) scores, while the Calgary Sleep Apnea Quality of Life Index (SAQLI) scores increased(P＜0.05). After 6 months of treatment, the observation group had lower PSQI scores and higher SAQLI scores compared to the control group(P＜0.05). After 6 months of treatment, the serum levels of TNF-α and NF-kB decreased in both groups(P＜0.05). After 6 months of treatment, the observation group had lower levels of serum TNF-α and NF-kB compared to the control group(P＜0.05). Conclusion: Uvulopalatopharyngoplasty combined with pharyngeal cavity and genioglossus muscle exercise can improve the therapeutic effect of OSAHS, regulate inflammatory response, and improve sleep structure, sleep quality, and quality of life. |
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