Mehmet EKİCİ, Aydanur EKİCİ, Erol ŞENTÜRK, Emel BULGUN, Tülay KARAKOÇ, Gökhan TİRELİ, Volkan ALTINKAYA

Bronchial hyperresponsiveness in patients with obstructive sleep apnea syndrome

Giriş: Obstrüktif uyku apne sendromu (OUAS) ve bronş hiperreaktivitesi (BHR) arasındaki ilişki iyi bilinmemektedir. Bu çalışmada, OUAS'lı hastalarda hastalığın şiddeti ve BHR arasındaki ilişkiyi araştırdık.Materyal ve Metod: Bu çalışmaya polisomnografileriyle OUAS tanısı alan 47 (37'si erkek, 10'u kadın) hasta alındı. Histamin provokasyon testi yapıldı ve beden kitle indeksi (BKİ, kg/m2) hesaplandı. BHR'nin varlığı bronş provokasyon test (BPT) pozitifliği (PD değerleri ≤ 16 mg/mL) olarak tanımlandı. Hastalar Epworth uyku skalası (EUS) ile sorgulandı.Bulgular: Kırk yedi hastanın 21'inde histamin provokasyon testi pozitifti. BHR'li hastalarda PD 20 değeri ile apne-hipopne indeksi (AHİ) (r= -0.47, p= 0.03), BKİ (r= -0.45, p= 0.03) ve EUS skoru (r= -0.45, p= 0.03) arasında negatif ilişki vardı. Bununla birlikte, BHR'li hastalarda (21 hasta) AHİ (p= 0.03), BKİ (p= 0.02), EUS skoru (p= 0.03) BHR'ye sahip olmayan hastalardan (26 hasta) daha yüksekti. Multipl regresyon analizinde yaş ve cinsiyetten bağımsız olarak PD değeri ve AHİ (b= -0.45, p= 0.03) arasında negatif ilişki bulundu ve BHR'nin varlığı ile AHİ (p= 0.04) ve BKİ (p= 0.03) arasında pozitif ilişki bulundu.Sonuç: OUAS'lı hastalarda BHR yaygındır. OUAS'ın şiddeti arttıkça BHR'nin şiddeti artar. Bununla birlikte, obezite OUAS'lı hastalarda BHR'nin varlığını tetikleyebilir.

Obstrüktif uyku apne sendromu tanılı hastalarda bronş hiperreaktivitesi

Introduction: The relationship between obstructive sleep apnea syndrome (OSAS) and bronchial hyperresponsiveness (BHR) is not well known. In this study, we investigated the association between BHR and disease severity in patients with OSAS.Materials and Methods: Fourty seven (37 male/10 female) OSAS patients admitted with polysomnography enrolled to the study. Histamine bronchial challenge test was performed and body mass index (BMI, kg/m2) was calculated. Presence of BHR was diagnosed as positivity of bronchial provocative test (BPT) (PD values ≤ 16 mg/mL). Patients were questioned with Epworth sleepiness scale (ESS).Results: Histamine bronchial challenge test was positive in 21 of 47 patients. There were significant negative correlations between PD 20 value and AHI (r= -0.47, p= 0.03), BMI (r= -0.45, p= 0.03), and ESS score (r= -0.45, p= 0.03) in the patients with BHR. In addition, AHI (p= 0.03), BMI (p= 0.02), ESS scores (p= 0.03) were higher in patients with BHR (21 patients) than in patients not having BHR (26 patients). Significant negative relation was found between PD 20 value and AHI (b=-0.45, p= 0.03) and significant positive relation was found between presence of BHR and AHI (p= 0.04), BMI (p= 0.03) independently of age and sex in multiple regression analysis.Conclusion: BHR is common in patients with OSAS. As severity of OSAS increased, severity of BHR increased. In addition, obesity may trigger presence of BHR in patients with OSAS.

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