单纯鼾症及阻塞性睡眠呼吸暂停低通气综合征患者上气道CT扫描影像参数观察  

CT image observation in the upper airway in simple snoring and obstructive sleep apnea hypopnea syndrome patients

作　　者：龚为群 阎萍 肖宽林[2] 冯云海 王钢[3] 任霞斌 

机构地区：[1]上海市徐汇区大华医院耳鼻咽喉科,上海200237 [2]复旦大学附属眼耳鼻喉科医院耳鼻喉科,上海200031 [3]上海市徐汇区大华医院放射科,上海200237

出　　处：《中国眼耳鼻喉科杂志》2011年第1期16-18,71,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：上海市卫生局科研课题(2008173)

摘　　要：目的观察螺旋CT扫描技术用于确定阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS))患者上气道阻塞平面的价值。方法对25例单纯鼾症及25例OSAHS患者,分别在平静呼吸和Mller呼吸时行螺旋CT扫描,扫描范围从第1颈椎上缘至第6颈椎下缘。借助CT三维重建工作站自带软件,分别测量两种状态下C2上缘、悬雍垂根部、C3上缘及C3下缘处的上气道截面积、矢状位前后径和冠状位左右径,并进行对比分析。结果 OSAHS患者在平静呼吸和Mller呼吸时,C2上缘和悬雍垂根部的冠状位左右径和横截面积较单纯鼾症组相应层面参数小(P<0.05)。OSAHS患者在平静呼吸时,C3上缘处冠状位左右径、矢状位前后径及横截面积,C3下缘处冠状位左右径及横截面积较单纯鼾症组小(P<0.01)。OSAHS患者在Mller呼吸时,C3上缘处冠状位左右径,C3下缘处矢状位前后径较单纯鼾症组少(P<0.01)。结论 OSAHS患者上气道狭窄表现在多个平面。螺旋CT扫描能够客观、可重复性地测量上气道的径线及横截面积。Objective To evaluate the value of CT scan in the localization of obstruction sites in the upper airway in subjects with obstructive sleep apnea hypopnea syndrome（OSAHS）. Methods Spiral CT scan was performed in 25 snoring subjects and 25 OSAHS patients during resting and Muller respiration respectively. The scanning range was from the upper edge of the first cervical vertebra to the lower edge of the sixth cervical vertebra. The parameters including the cross-sectional area, sagittal anteroposterior diameter and coronal transverse diameter of the upper edge of the second cervical vertebra, uvula root, the upper edge of the third cervical vertebra and the lower edge of the third cervical vertebra in resting and Muller respiration were measured and compared by using the sofiwares of the three-dimensional reconstruction workstation. Results Both under the resting and Muller respiration, the transverse diameter and the cross-sectional area of the upper edge of the second cervical vertebra and the uvula root in the OSAHS patients was smaller than that in the snoring subjects respectively（P 〈 0.05）. During the resting respiration, the transverse diameter, anteroposteriot diameter and cross-sectional area of the upper edge of the third cervical vertebra in OSAHS patients was smaller than that in the snoring subjects respectively （P 〈0.01 ）. Under the Muller respiration, the transverse diameter of the upper edge of the third cervical vertebra and the auterioposterior diameter of the lower edge of the third cervical vertebra in OSAHS patients was smaller than that in the snoring subjects respectively （ P 〈 0.01 ）. Conclusions Multi-planar obstruction could be observed in OSAHS patients. Spiral CT could measure the diameter and the cross section area of the upper airway accurately and repeatedly. （ Chin J Ophthalmol and Otorhinolaryngol,2011,11 ： 16-18 ）

关 键 词：睡眠呼吸暂停 阻塞性 体层摄影术 Mller呼吸 平静呼吸 

分 类 号：R766[医药卫生—耳鼻咽喉科]