阻塞性睡眠呼吸暂停低通气综合征患者舌后区呼吸道狭窄CT探究.docVIP

阻塞性睡眠呼吸暂停低通气综合征患者舌后区呼吸道狭窄CT探究 　【摘要】 目的：研究阻塞性睡眠呼吸低通气暂停综合征(obstructive sleep apnea hypopnea syndrome，OSAHS)患者舌后区上呼吸道的CT影像，探讨舌后区呼吸道狭窄的原因。方法：对经多导睡眠监测系统(polysomnography, PSG)确诊的100例OSAHS患者，采用螺旋CT行上呼吸道连续扫描，测量舌后区呼吸道横截面积，对存在舌后区呼吸道狭窄（24例）和无舌后区呼吸道狭窄（76例）的两组患者进行对比研究。结果：两组患者的一般临床资料无明显差别，舌后区狭窄组的舌后区呼吸道左右径、前后径明显小于非狭窄组，狭窄组的咽后壁、咽侧壁软组织厚度、舌体宽度、舌体长度和舌体截面积等CT测量数据明显大于非狭窄组。结论：24%的OSAHS患者存在舌后区上呼吸道狭窄，除舌体肥厚外，咽侧壁和咽后壁的软组织增厚也是导致舌后区呼吸道狭窄的重要原因。 【关键词】 睡眠呼吸低通气暂停综合征 阻塞性 体层摄影术 X线 计算机 上呼吸道 气道梗阻 舌 ［ABSTRACT］ Objective: To study the CT imaging of upper airway at the lingual region stricture for obstructive sleep apnea hypopnea (OSAHS) patients and to explore its meaning. Methods: One hundred patients with OSAHS were enrolled in this study and divided into two groups: the stricture group (24 cases) and the nonstricture group (76 cases). The dimension of the lingual region airway, the thickness of the retropharyngeal and the lateral pharyngeal tissue， and the width and length of the tongue were determined. Results: There was no difference of age, BMI, AHI and pulse oxygen between the stricture group and the nonstricture group. The coronal and the arrow diameters of the stricture group were less than those of the nonstricture group. The thickness of the retropharyngeal and lateral pharyngeal wall, and the width and length of the tongue of the stricture group were larger than those of the nonstricture group. Conclusion: Lingual region stricture occurs in about 24% of patients with OSAHS, which may be caused by the incrassation of the retropharyngeal and lateral pharyngeal wall and fleshy tongue. ［KEY WORDS］ Sleep apnea hypopnea syndrome, obstructive; Tomography, Xray, computer; Upper airway; Obstruction of airway; Tongue OSAHS发病率逐年提高，它的发生受多种因素影响，其中上呼吸道解剖性狭窄是主要原因之一［1］。近年来有研究表明［2］，除了口咽区外，OSAHS患者的另一个常见上呼吸道狭窄部位为舌后区呼吸道。对舌后区呼吸道有无解剖性狭窄以及造成狭窄的原因进行正确的评估，有助于改善OSAHS患者手术治疗的效果。CT可以精确测定上呼吸道的横截面积、各径线的长度以及咽壁的厚度等，我们的既往研究发现［3］，正常人和OSAHS患者舌后区上呼吸道横截面积等测量指标存在明显差异，并制定了正常人舌后区上呼吸道测量的正常值范围［4］。现报告经PSG确诊的100例OSAHS患者的舌后区气道以及