A Preliminary Study On The Relationship Between Laryngopharyngeal Reflux And Obstructive Sleep Apnea-hypopnea Syndrom

Objective:To investigate the relationship between obstructive sleep apnea-hypopnea syndrome and laryngopharyngeal reflux by detecting the expression of pepsin in the soft palate mucosa of patients with obstructive sleep apnea-hypopnea syndrome,and to provide new directions for the diagnosis and treatment of the disease.Methods:Seventy patients who attended the ENT departments of the Affiliated Hospital of Chengde Medical College,the Sixth Medical Center of the General Hospital of the Chinese People’s Liberation Army and Beijing Changgeng Hospital from November 2018 to November 2020 and underwent surgical treatment were selected,and the soft palate mucosal tissues of 70 patients were tested for pepsin using immunohistochemical staining,and the intensity of pepsin expression was correlated with the degree of obstructive sleep apnea-hypopnea syndrome condition.The sensitivity and specificity of RSI and RFS scales were evaluated for each patient,using pepsin positivity as the gold standard for the diagnosis of laryngopharyngeal reflux.The difference was considered statistically significant at P<0.05.Results:Pepsin expression in the soft palate mucosal tissue of 70 OSAHS patients was strongly positive in 13(18.57%),positive in 26(37.14%),weakly positive in 23(32.86%),and negative in 8(11.43%).RSI≥13 points in 55 cases(78.57%),RFS≥7 points in 50 cases(71.43%),RSI≥13 points or RFS≥7 points in 58 cases(82.86%).The sensitivity of RSI,RFS and RSI combined with RFS score results were 83.87%,77.42%and 93.55%,respectively,and the specificity was 62.50%,75%and 37.50%,respectively.The results of Spearman rank correlation analysis suggested that the difference was statistically significant,and there was a significant positive correlation between the degree of obstructive sleep apnea-hypopnea syndrome and pepsin expression intensity.(r=0.568,P<0.05).Conclusion:There is a significant correlation between obstructive sleep apnea-hypopnea syndrome and laryngopharyngeal reflux,which is an important factor in the development of obstructive sleep apnea-hypopnea syndrome.The RSI and RFS scales have a high sensitivity and can be used as a preliminary screening method for the presence of laryngopharyngeal reflux in patients with obstructive sleep apnea-hypopnea syndrome.