阻塞性睡眠呼吸暂停低通气综合征患者上气道CT测量值及睡眠呼吸暂.docVIP

阻塞性睡眠呼吸暂停低通气综合征患者上气道CT测量值及睡眠呼吸暂 　【摘要】 目的 应用多层螺旋CT对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的上气道成像，探讨上气道各平面的测量参数与睡眠呼吸暂停低通气指数(AHI)的相关性。方法 经多导睡眠监测（PSG）确诊的42例OSAHS的患者行平静呼吸和深吸气末时的上气道CT扫描，测量上气道各平面的截面积及相应平面的左右径和前后径并计算气道塌陷度。结果 OSAHS患者上气道最小截面积主要位于腭后区；中度组与重度组患者腭后区不同时相各测量指标与AHI呈负相关，舌后区深吸气末各测量指标与AHI呈负相关；各组患者各平面塌陷度与AHI无相关性。结论 OSAHS患者气道塌陷度与AHI无明显相关性。 【关键词】 睡眠呼吸暂停低通气综合征 阻塞性 体层摄影术 X线 计算机 呼吸暂停低通气指数 Abstract: Objective To investigate the relationship between upper airway CT measurements and apnea hypopnea indexes of patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods The pharynxes of 42 patients with OSAHS were scanned by CT during normal respiration and deep inspiration. CT measurements were made in crosssection areas with their corresponding sagittal and transverse diameters, and their pharyngeal collapsibility was also determined. Results （1） The smallest crosssection area of OSAHS was at the velopharyngeal level. (2) At the velopharyngeal level CT measurements were negatively correlated with AHI during normal respiration and deep inspiration, and at the tonguepharyngeal level CT measurements were negatively correlated with AHI during deep inspiration in moderate and serious OSAHS. (3) The collapsibility of different pharynx levels was not correlated with AHI in all cases. Conclusions The collapsibility of different pharynx levels has no correlation with AHI. Key words: Sleep apnea hypopnea syndrome, obstructive；Tomography, Xray, computed； Apnea hypopnea index 　　阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apneahypopnea syndrome, OSAHS）的发生受多种因素的影响，其中上呼吸道多平面解剖性狭窄和局部软组织的塌陷性增强是原因之一［12］。因此充分认识和研究OSAHS患者的上气道形态学对患者的诊断和综合序列治疗有重要的意义。本研究通过对OSAHS患者上气道CT各平面的测量参数与睡眠呼吸暂停低通气指数（apneahypopnea index, AHI）的相关性分析，探讨不同程度OSAHS患者上气道阻塞平面各指标与AHI的关系。 1 资料与方法 1.1 研究对象 随机选择我院耳鼻咽喉科于2004年1月至2005年12月连续收治的OSAHS患者42例，其中男38例，女4例；40 55岁，平均46.7岁。平均体重指数28.15±0.46，平均颈围（41.67±0.38）cm。采用美国伟康公司Alice 4 PSG系统对所有患者进行睡眠监测，平均呼吸暂停低通气指数为(47.62±6.27)次/h。所有患者均符合OSAHS诊断标准［3］，排除颅面部畸形及呼吸中枢性睡眠暂停综合征。依据2002年中华医学会耳鼻咽喉科学分会、中华耳鼻咽喉