AMP矫治器治疗OSAHS前后的头影测量分析  

Cephalometric measurement of obstructive sleep apnea and hyponea syndrome treated with anterior mandible position appliance

作　　者：徐辉[1] 唐成忠[1] 李益材[1] 翁志强[1] 汤学华[1] 

机构地区：[1]南京军区南京总医院口腔科,江苏南京210002

出　　处：《临床口腔医学杂志》2004年第7期423-426,共4页Journal of Clinical Stomatology

摘　　要：目的 :对AMP (anteriormandibularpositioner ,AMP)矫治器 (一种前移下颌的口腔矫治器 )进行疗效研究 ,并探讨其引起颌面结构的变化和可能影响疗效的颌面结构参数。方法 :5 6例OSAHS患者 ,经夜间多导睡眠图检查确诊 ,戴用AMP矫治器 1～ 2个月后复查多导睡眠图 ,拍摄术前术后的X线头颅定位侧位片 ,比较颌面结构的变化。按治疗后AHI <10、10≤AHI≤ 2 0及AHI >2 0分为 3组 ,前 2组为有效组 ,后 1组为无效组 ,比较 3组颌面结构差异 ,并研究可能影响疗效的因素。结果 :AMP使颏顶点前移 ,舌骨相对下颌上移 ,舌体前移 ,软腭与舌背接触减小 ,PAS增大 ;下颌前移的程度 ,舌骨 -下颌平面距 ,上下颌骨矢状方向上的差异 ,前面高 /后面高比值与AMP疗效有关。结论 :AMP是一种有效的、较为理想的治疗OSAHS的非手术方法。值得注意的是 ,患者颅颌面结构特征不同 ,有可能影响疗效 ,提示应根据颌面结构特点设计和制作AMP ,以减轻不良反应 。Objective:This study was to investigate the efficacy of one type of the advanced mandible devices, which is named AMP (anterior mandible position) appliance, analyze the changes of cephaolometric measurements of the craniofacial structures caused by AMP and explore the possible craniofacial parameters that could predict responses to such a device. Method:50 male and 6 female OSAHS patients were enrolled. All had completed one night polysomnographic examination and been diagnosed as OSAHS. After 1-2 months when AMP has been used, a second polysomnography has been done with AMP inserted. The lateral cephalomegrams of 56 patients were taken before and after treatment in order to investigate the changes of cephalometric measurements caused by AMP device. All patients were classified into 3 groups based on their post-treatment AHI values (AHI<10、10≤AHI≤20 and AHI>20). The differences in craniofacial structure among those groups were compared, and the possible variables involved in the effects of treatment were explored.Result:The study shows some cephalometric changes, such as that the pg point was advanced, the distance of AH-MP was shortened, the position of the tongue was modified, the length of CL was reduced, and the space at the site of PASmin was enlarged, et al; Four factors might play an important role in the results, which were advanced distance of the mandible, the distance of AH-MP, the discrepancy between maxilla and mandible, and the value of MP/FH anger. Conclusion:This study shows that AMP can be used as an efficient and ideal nonsurgical alternative to treat OSAHS. It should be paid more attentions that the characteristics of the craniofacial structures might exert some influences on the efficacy, and it implies that design and fabrication of AMP should be in accordance with those characteristics in order to obtain the most effective results.

关 键 词：口腔矫治器 阻塞性睡眠呼吸暂停 低通气综合症 头影测量分析 

分 类 号：R814[医药卫生—影像医学与核医学]