患有鼻窦炎的非洲裔美国人发生阻塞性睡眠呼吸暂停的危险性
2017/11/20
摘要
背景：众所周知，患有慢性鼻窦炎（CRS）的患者通常会发生睡眠呼吸暂停。其中许多患者被诊断为阻塞性睡眠呼吸暂停（OSA）。然而，只有少数人知道在慢性鼻窦炎患者中发生阻塞性睡眠呼吸暂停的危险因素。
目的：我们研究慢性鼻窦炎患者发生阻塞性睡眠呼吸暂停的危险因素，探讨CRS患者出现OSA的筛查方法。
方法：我们对许多确诊为CRS的患者进行了评估。回顾性分析了这些通过多导睡眠图确诊为OSA患者的医疗记录。我们对人口统计学信息（年龄、性别、家庭、种族）、体重指数和包括鼻息肉、哮喘、阿司匹林相关的呼吸系统疾病、过敏性鼻炎、湿疹等病史记录进行分析。此外，我们还分析了内镜下鼻窦手术次数、CRS的持续时间、主观性嗅觉丧失、Lund-Mackay CT评分等。
结果：共有916位CRS患者被纳入了这项研究。危险因素的多变量回归模型结果表明非洲裔美国人患OSA的风险比白人高，校正后的比值比为1.98（95%可信区间，1.19-3.29）。此外，没有鼻息肉的CRS患者较有鼻息肉的CRS患者患OSA的风险更高，比值比为1.63（95%可信区间，1.02-2.61）。
总结：患有CRS的非裔美国人患阻塞性睡眠呼吸暂停综合症的风险高于白人患者，因而这一患者群体有必要进行OSA的筛查。
Risk of obstructive sleep apnea in African American patients with chronic rhinosinusitis.
Hui JW, Ong J, Herdegen JJ, Kim H, Codispoti CD, Kalantari V, Tobin MC, Schleimer RP, Batra PS, LoSavio PS, Mahdavinia M.
Abstract
BACKGROUND:It is widely known that patients with chronic rhinosinusitis (CRS) commonly experience sleep disruption. Many of these patients have the associated diagnosis of obstructive sleep apnea (OSA). However, little is known about the risk factors for developing OSA in the CRS population.
OBJECTIVE:To identify the risk factors for OSA in CRS to determine who should be screened for OSA among patients with CRS.
METHODS:We evaluated a large cohort of patients with confirmed diagnostic criteria for CRS. Patient medical records were reviewed to identify those with OSA confirmed by overnight polysomnography. Records were further reviewed for demographic information (age, sex, race, and ethnicity), body mass index, and medical history, including the presence of nasal polyps, asthma, aspirin-exacerbated respiratory disease, allergic rhinitis, and eczema. The number of endoscopic sinus operations, duration of CRS, presence of subjective smell loss, and computed tomography Lund-Mackay score were also ascertained.
RESULTS:A total of 916 patients with CRS were included in the study. Implementation of a multivariable regression model for identifying adjusted risk factors revealed that African American patients had a significantly higher risk for OSA than white patients, with an adjusted odds ratio of 1.98 (95% confidence interval, 1.19-3.29). Furthermore, patients with CRS without nasal polyps were at higher risk for OSA, with an odds ratio of 1.63 (95% confidence interval, 1.02-2.61) compared with patients with CRS with nasal polyps.
CONCLUSION:African American patients with CRS were at higher risk for OSA compared with white patients, and this patient group needs to be screened for OSA.
背景：众所周知，患有慢性鼻窦炎（CRS）的患者通常会发生睡眠呼吸暂停。其中许多患者被诊断为阻塞性睡眠呼吸暂停（OSA）。然而，只有少数人知道在慢性鼻窦炎患者中发生阻塞性睡眠呼吸暂停的危险因素。
目的：我们研究慢性鼻窦炎患者发生阻塞性睡眠呼吸暂停的危险因素，探讨CRS患者出现OSA的筛查方法。
方法：我们对许多确诊为CRS的患者进行了评估。回顾性分析了这些通过多导睡眠图确诊为OSA患者的医疗记录。我们对人口统计学信息（年龄、性别、家庭、种族）、体重指数和包括鼻息肉、哮喘、阿司匹林相关的呼吸系统疾病、过敏性鼻炎、湿疹等病史记录进行分析。此外，我们还分析了内镜下鼻窦手术次数、CRS的持续时间、主观性嗅觉丧失、Lund-Mackay CT评分等。
结果：共有916位CRS患者被纳入了这项研究。危险因素的多变量回归模型结果表明非洲裔美国人患OSA的风险比白人高，校正后的比值比为1.98（95%可信区间，1.19-3.29）。此外，没有鼻息肉的CRS患者较有鼻息肉的CRS患者患OSA的风险更高，比值比为1.63（95%可信区间，1.02-2.61）。
总结：患有CRS的非裔美国人患阻塞性睡眠呼吸暂停综合症的风险高于白人患者，因而这一患者群体有必要进行OSA的筛查。
（复旦大学附属中山医院呼吸内科 包晨 摘译 杨冬 审校）
（Ann Allergy Asthma Immunol. 2017;118(6):685-688.e1.）
（Ann Allergy Asthma Immunol. 2017;118(6):685-688.e1.）
Risk of obstructive sleep apnea in African American patients with chronic rhinosinusitis.
Hui JW, Ong J, Herdegen JJ, Kim H, Codispoti CD, Kalantari V, Tobin MC, Schleimer RP, Batra PS, LoSavio PS, Mahdavinia M.
Abstract
BACKGROUND:It is widely known that patients with chronic rhinosinusitis (CRS) commonly experience sleep disruption. Many of these patients have the associated diagnosis of obstructive sleep apnea (OSA). However, little is known about the risk factors for developing OSA in the CRS population.
OBJECTIVE:To identify the risk factors for OSA in CRS to determine who should be screened for OSA among patients with CRS.
METHODS:We evaluated a large cohort of patients with confirmed diagnostic criteria for CRS. Patient medical records were reviewed to identify those with OSA confirmed by overnight polysomnography. Records were further reviewed for demographic information (age, sex, race, and ethnicity), body mass index, and medical history, including the presence of nasal polyps, asthma, aspirin-exacerbated respiratory disease, allergic rhinitis, and eczema. The number of endoscopic sinus operations, duration of CRS, presence of subjective smell loss, and computed tomography Lund-Mackay score were also ascertained.
RESULTS:A total of 916 patients with CRS were included in the study. Implementation of a multivariable regression model for identifying adjusted risk factors revealed that African American patients had a significantly higher risk for OSA than white patients, with an adjusted odds ratio of 1.98 (95% confidence interval, 1.19-3.29). Furthermore, patients with CRS without nasal polyps were at higher risk for OSA, with an odds ratio of 1.63 (95% confidence interval, 1.02-2.61) compared with patients with CRS with nasal polyps.
CONCLUSION:African American patients with CRS were at higher risk for OSA compared with white patients, and this patient group needs to be screened for OSA.
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