快速眼动相关阻塞性睡眠呼吸暂停：预测腭部手术后良好结局的生理表型
Rapid eye movement-related obstructive sleep apnea: a physiological phenotype predicting favorable outcomes following palatal surgery.
文献信息
| PMID | 42760362 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ya-Wei Hsiao |
| 作者单位 | Department of Otorhinolaryngology, Head and Neck Surgery, Sleep Center, Linkou Medical Center, Chang Gung Memorial Hospital, No. 5, Fu-Hsing Street, Gueishan District, Taoyuan City, 33305, Taiwan. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
目的： 快速眼动相关阻塞性睡眠呼吸暂停（REM-OSA）是OSA的一种生理表型，其临床意义及对手术结局的影响尚不明确。本研究评估了REM-OSA的患病率、临床特征及其对腭部手术结局的预测价值。
方法： 回顾性分析接受腭部手术且无法耐受持续气道正压通气的成年OSA患者。REM-OSA定义为REM期呼吸暂停低通气指数（AHI）至少为非REM期AHI的两倍。手术成功定义为AHI降低>50%且术后AHI<20次/小时。采用逻辑回归分析确定手术成功的预测因素。
结果： 在90例患者中，24例（26.7%）患有REM-OSA。与非REM-OSA相比，REM-OSA患者更年轻（35.9岁 vs. 39.3岁，p=0.043），基线AHI更低（36.4次/小时 vs. 52.0次/小时，p=0.005）。尽管两组AHI降低程度相似，但REM-OSA的手术成功率显著更高（79.2% vs. 53.0%，p=0.007）。调整年龄和基线AHI后，REM-OSA仍是手术成功的独立预测因素（调整后OR 5.44，95% CI 1.41-21.00，p=0.014）。
结论： REM-OSA与较年轻年龄和较低基线疾病严重程度相关。尽管腭部手术后AHI绝对降低值在两组间相当，但REM-OSA患者的手术成功率显著更高。这些发现表明，REM-OSA可能作为腭部手术后良好结局的临床有用预测指标。
英文摘要
PURPOSE: Rapid eye movement-related obstructive sleep apnea (REM-OSA) is a physiological phenotype of OSA whose clinical significance and impact on surgical outcomes remain unclear. This study evaluated the prevalence, clinical characteristics, and predictive value of REM-OSA for palatal surgery outcomes.
METHODS: Adult patients with OSA intolerant of continuous positive airway pressure who underwent palatal surgery were retrospectively reviewed. REM-OSA was defined as a REM apnea-hypopnea index (AHI) at least twice the non-REM AHI. Surgical success was defined as a > 50% reduction in AHI and a postoperative AHI < 20 events/hour. Logistic regression was performed to identify predictors of surgical success.
RESULTS: Among 90 patients, 24 (26.7%) had REM-OSA. Compared with NREM-OSA, REM-OSA patients were younger (35.9 vs. 39.3 years, p = 0.043) and had lower baseline AHI (36.4 vs. 52.0 events/hour, p = 0.005). Although AHI reduction was similar between groups, REM-OSA showed a significantly higher surgical success rate (79.2% vs. 53.0%, p = 0.007). REM-OSA remained an independent predictor of surgical success after adjustment for age and baseline AHI (adjusted OR 5.44, 95% CI 1.41-21.00, p = 0.014).
CONCLUSIONS: REM-OSA was associated with younger age and lower baseline disease severity. Although the absolute reduction in AHI following palatal surgery was comparable between groups, patients with REM-OSA achieved a significantly higher surgical success rate. These findings suggest that REM-OSA may serve as a clinically useful predictor of favorable outcomes following palatal surgery.