睡眠呼吸中止與嗅覺功能異常之相關性研究

Abstract

前言：睡眠呼吸中止(Sleep apnea, SA)為於睡眠時上呼吸道重複性的完全或部分的阻塞造成睡眠的中斷及導致慢性缺氧。慢性缺氧會造成系統性的發炎而引發許多的併發症 如高血壓、增加腦血管及心血管疾病的風險。睡眠對於嗅覺功能有著重要的角色，然而睡眠呼吸中止症對於嗅覺功能障礙的相關性尚未研究清楚；此論文目的即是使用台灣族群的就醫資料來研究睡眠呼吸中止症對於嗅覺功能障礙的影響。 研究方法：利用國家衛生研究院所發行的全民健康保險研究資料庫，此次研究是使用於西元2000年所抽樣的100萬人(Longitudinal Health Insurance Database 2000, LHID2000)。最後篩選出493位嗅覺功能障礙病人及9860位對照組病人來進行分析；使用logistic regression方法來計算睡眠呼吸中止對於嗅覺功能障礙病人的危險性(odds ratio, OR)。 結果：於2000至2012年研究期間，共678168人進行分析；睡眠呼吸中止的盛行率在一般族群及嗅覺功能障礙病人分別為0.43%及2.03%。在univariate logistic regression分析顯示睡眠呼吸中止為嗅覺功能障礙的危險因子(Crude OR 4.84, 95% CI 2.41 - 9.70)；而在調整其他干擾因子後，睡眠呼吸中止仍然為嗅覺功能障礙的危險因子(Adjusted OR 2.47, 95% CI 1.18 - 5.18) 。除此之外，在進行multivariate logistic regression後，較大的年紀(大於40歲)、鼻或鼻竇疾病(sinonasal disorders)及慢性肝疾病(chronic liver diseases) 也是嗅覺功能障礙的危險因子。 結論：研究顯示睡眠呼吸中止為嗅覺功能障礙的危險因子；另外較大的年紀、鼻或鼻竇疾病及慢性肝炎可能也是嗅覺功能障礙的致病因子。

Background: Sleep apnea (SA) is a common sleep disorder characterized by chronic sleep fragmentation and intermittent hypoxia (IH). Chronic IH induces systemic inflammatory processes which are associated with hypertension, as well as an incremental risk of developing cerebrovascular and cardiovascular diseases. Sleep plays an important role in normal olfactory function. However, it is unclear the impact of sleep apnea on olfactory dysfunction. The aim of this study was to evaluate the association between olfactory dysfunction and SA in a Taiwanese population. Methods: This study used data from the Longitudinal Health Insurance Database 2000 (LHID2000) which was selected form the National Health Insurance Research Database (NHIRD) in Taiwan and selected 493 olfactory dysfunction patients and 9860 control patients finally. A multivariate logistic regression analysis was used to calculate the odds ratios (ORs) for SA in the olfactory dysfunction and control patients. Results: During the research period from 2000 to 2012, total 678168 patients were encompassed in this study. The prevalence of SA was 0.43% and 2.03% in general population and patient with olfactory dysfunction, respectively. SA was a risk factor for olfactory dysfunction (crude OR 4.84, 95% CI 2.41 - 9.70) in univariate logistic analysis. After adjusting confounding factors including gender, age and all comorbidities, SA still was a risk factor for olfactory dysfunction (adjusted OR 2.47, 95% CI 1.18 - 5.18). In addition, old age, sinonasal disorders and chronic liver diseases also were potential risk factors. Conclusion: The result of the present study indicate that SA was potential cause of olfactory dysfunction. Other potential causes included sinonasal disorders、older age and chronic liver diseases.