舌腭关系分型对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的预测意义  

Relationship of lingual region upper airway stricture and lingua-palate position type in obstructive sleep apnea hypopnea syndrome patients

作　　者：李树华[1] 石洪金[1] 吴大海[1] 董卫东[1] 邹连贵[1] 刘嵘[2] 

机构地区：[1]解放军沈阳军区总医院耳鼻咽喉科,沈阳110016 [2]中国医科大学统计学教研室

出　　处：《中华耳鼻咽喉头颈外科杂志》2007年第12期910-914,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：国家科技攻关计划资助课题(2004BA720A17)

摘　　要：目的研究阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopneasyndrome,OSAHS)患者舌腭关系分型与舌后区上呼吸道狭窄的关系。方法经多道睡眠监测确诊的OSAHS 患者共100例,采用螺旋 CT 对上呼吸道进行连续扫描,对舌后区呼吸道各参数进行测量,对比研究不同 Friedman 舌腭关系分型组间舌后区呼吸道各测量参数和舌后区呼吸道狭窄发生率的差别,并采用多元逐步回归分析探讨影响舌腭关系分型的因素。结果不同舌腭关系分型的 OSAHS 患者的一般临床资料无统计学差异(P 值均>0.05),从舌腭关系Ⅰ型到Ⅳ型,舌后区呼吸道截面积和内径逐渐缩小,舌体长度和舌截面积逐渐增加,舌后区呼吸道狭窄的发生率逐渐增高,Ⅰ型到Ⅳ型患者组中发生舌后区呼吸道狭窄的比率分别为0/25、3/39、7/22、14/14,差异有统计学意义(P 值均<0.05)。多元逐步回归分析证实影响舌腭关系分型最显著因素为舌后区呼吸道截面积,偏回归系数为-0.39,复相关系数为-0.545。,结论舌腭关系分型与舌后区呼吸道狭窄有明显相关关系,临床可以通过对舌腭关系分型的观察来初步判断舌后区呼吸道状态。Objective To explore the relationship of lingual region upper airway stricture and lingua-palate position type in obstructive sleep apnea hypopnea syndrome （OSAHS） patients. Methods One hundred patients with OSAHS were included in the study and divided into 4 groups by lingua-palate age, AHI, BMI and lowest SaO2, the dimensions and area of lingual region airway, the thickness of retropharyngeal and lateral pharyngeal tissue, the tongue width, tongue length and tongue area were compared among four groups. The multinomial step regression process was performed with SPSS software to explore the effects of lingua-palate position type on lingual region upper airway stricture. Results There were no statistical difference of age, BMI, AHI and lowest pulse oxygen among four groups OSAHS patients（ P 〉 0. 05 ）. And the CT results showed： starting from type Ⅰ to type Ⅳ, the area, coronal and arrowy diameter of lingual region upper airways were decreasing, tongue length, tongue area and the percentage of lingual region airway stricture were increasing, the percentage of lingual region airway stricture were 0/25,3/39, 7/22,14/14, respectively （P 〈 0. 05 ）. The multinomial step regression analysis showed that the area of lingual airway was the most important factor of lingua-palate position type, the unstandardized coefficient was - 0. 39, and standardized coefficient was - 0. 545. Conclusions The study suggests that there is evident correlation between lingual region airway stricture and lingua-palate position type, and lingual region airway stricture can be roughly determined by lingua-palate position type.

关 键 词：睡眠呼吸暂停 阻塞性 体层摄影术 X线计算机 舌 腭 气道梗阻 

分 类 号：R766[医药卫生—耳鼻咽喉科]