儿童颅面和气道形态与阻塞性睡眠呼吸暂停低通气综合征关系的病例-对照研究  

Relationship between craniofacial and airway structure and pediatric obstructive sleep apnea and hyponea syndromes:a case-control study

作　　者：邓金荣[1] 高雪梅[1] 曾祥龙[1] 

机构地区：[1]北京大学口腔医学院.口腔医院正畸科,北京100081

出　　处：《北京大学学报（医学版）》2010年第6期697-702,共6页Journal of Peking University:Health Sciences

基　　金：首都科学发展科研基金(2007-3009)资助~~

摘　　要：目的:探讨儿童阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea and hyponea syndromes,OSAHS)患者与正常儿童的颅面和气道形态差异,从结构上分析儿童OSAHS的潜在病因。方法:本研究为病例对照研究,共纳入15名经夜间多导睡眠监测(polysomnography,PSG)确诊的儿童OSAHS患者作为病例组和15名无睡眠呼吸障碍的少年儿童入对照组,纳入研究的病例组和对照组的患者在年龄和性别比例上严格匹配。应用头影测量的方法对两组颅面结构和气道的各项相关指标进行对比。结果:头颅侧位片的比较显示两组颅面形态存在明显差异,病例组鼻根点到下齿槽座点连线与前颅底平面的夹角(SNB)为(75.8±4.3)度,小于正常组[(78.7±2.6)度],且差异具有统计学意义(P=0.03)。病例组颏前点到鼻根点和下齿槽座点连线的距离(PG/NB)为(1.3±0.8)mm,大于正常组[(0.6±0.6)mm],且差异具有统计学意义(P=0.02)。病例组的全面高(N-Me)为(65.1±5.9)mm,较正常组[(61.5±3.2)mm]大,且差异具有统计学意义(P=0.04)。病例组舌骨到第三颈椎与颏下点连线的距离(H-C3Me)为(5.3±3.7)mm,大于正常组[(2.6±2.6)mm],差异有统计学意义(P=0.03)。病例组的腺样体的直径(A)为(2.2±0.7)mm和正常组的腺样体直径[(1.6±0.6)mm]相比,差异具有统计学意义(P=0.02)。扁桃体与气道的比例(T/P)病例组(1.4±0.4)高于对照组(0.8±0.3),差异有统计学意义(P=0.00)。结论:儿童OSAHS患者具有下颌后缩、颏部后缩、舌骨位置低、扁桃体和腺样体肥大、下面高增加的面型,儿童颅面和气道形态异常可能是其患OSAHS的潜在病因。Objective：The children obstructive sleep apnea and hyponea syndromes has become a global research hot spot,but the research of craniofacial features in obustructive sleep apnea and hyponea syndromes （OSAHS） children was scarce. To evaluate the craniofacial features of obustructive sleep apnea and hyponea syndromes children. Methods： The subjects involved in this study fell into two groups： the patient group and the control one. The patients and controls were strictly matched by age and sex. Lateral head radiographs and cephalometric measurements were obtained and then compared between the two groups. Results： The findings demonstrated marked differences in terms of SNB,PG-NB,lower facial height,H-C3Me and A＆T/P. The SNB angle （75.8±4.3）in the patient group was smaller than that in the control one（78.7±2.6）and the P value was 0.035; the PG/NB value in the patient group （1.3±0.8） mm was higher than that in the control one （0.6±0.6） mm and the P value was 0.02. The anterior face height was （65.1±5.9） mm in the patient group （P=0.04）,while the anterior face height in the control group was （61.5±3.2） mm. The position of hyoid was lower in the patient group（5.3±3.7） mm,compared with the control one（2.6±2.6） mm,and the P value was 0.03. Furthermore,the patients of OSAHS had more swelled adenoids and tonsils than the controls. Conclusion：The patient group differed from the control group in the length of mandible,lower facial height,position of hyoid and the chin,and the size of the adenoids and tonsils.

关 键 词：睡眠呼吸暂停 阻塞性 颅面骨畸形 测颅法 儿童 

分 类 号：R783[医药卫生—口腔医学]