中老年女性阻塞性睡眠呼吸暂停低通气综合征患者上气道形态功能研究  

Upper airway morphology and function study of middle-age and old women with OSAHS

作　　者：尹国平[1] 叶京英[2] 常青林[3] 伊彪[4] 

机构地区：[1]首都医科大学附属北京同仁医院,2007级博士研究生北京100730 [2]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),北京100730 [3]首都医科大学附属北京同仁医院放射线科,北京100730 [4]北京大学口腔医院口腔颌面外科,北京100081

出　　处：《中国耳鼻咽喉头颈外科》2008年第6期357-360,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：国家自然科学基金资助项目(30371249)

摘　　要：目的探讨上气道结构特点及顺应性改变在阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)发病中的作用。方法23例40岁以上女性,以呼吸暂停低通气指数(apnea and hypopnea index,AHI)为标准分为3组,比较X线头影测量片各指标的组间差异和不同呼吸状态下CT三维咽腔容积测量各部分容积的变化;观察各指标与OSAHS发病的相关性。结果在X线头影测量片各指标中,AHI<5次/小时组PAS、SNA角、SNB角和上气道最窄距离明显大于AHI>20次/小时组;5次/小时≤AHI≤20次/小时组的上气道最窄距离和SNA角明显大于AHI>20次/小时组。上气道最窄距离和SNA角在以AHI为因变量的回归方程中具有统计学意义,而以最低脉搏血氧饱和度为因变量的方程中,仅有MP-H有统计学意义。咽腔容积测量中,5次/小时≤AHI≤20次/小时组腭咽腔容积变化有统计学意义,AHI>20次/小时组中腭咽腔和舌咽腔容积改变有统计学差异。在以AHI为因变量的回归方程中腭咽腔容积变化率表现出统计学意义。结论上气道解剖结构异常是中老年女性OSAHS发病的形态学基础;上气道顺应性的增高在中老年女性OSAHS发病中起重要作用。OBJECTIVE To study the role of anatomic structure and compliance change of the upper airway in the pathogenesis of obstructive sleep apnea hypopnea syndrome （OSAHS） in middle-age and old women. METHODS Twenty-three OSAHS women over 40 years old were divided into three groups. The cephalometric items of different groups and the volume change of each pharyngeal subdivision measured by CT three-dimensional reconstruction were compared. Then the correlation between the measuring items and degree of the OSAHS was studied. RESULTS There was a statistic difference between group AHI 〈5/h and group AHI〉20/h in the items of PAS, SNA, SNB and narrowest pharyngeal distance. In the regression equation that AHI was as the dependent, only SNA and narrowest pharyngeal distance had statistic significance, while only MP-H was significant when the dependent was LSaO2. In the study of pharyngeal volume measurement, velopharyngeal volume during different breath states in the group 5≤AHI≤201h was statistically different, while the volume of glossopharynx and velopharynx showed the same change in group AHI 〉 20/h. In the regression equation that AHI was as the dependent, only volumetric change rate of vetopharynx had statistic significance. CONCLUSION Middle-age and old women with OSAHS have obvious anatomy abnormalities which are the morphological foundation of the OSAHS.Higher compliance of upper airway plays an important role in the OSAHS pathegenesis in middle-age and old women.

关 键 词：睡眠呼吸暂停 阻塞性 摄影测量法 成像 三维 成年人 妇女 

分 类 号：R766[医药卫生—耳鼻咽喉科]