AG200睡眠监测阻塞定位技术和螺旋CT评估OSAHS上气道狭窄的价值  

Evaluation of upper airway obstruction site in OSAHS by Apneagraph and spiral CT

作　　者：何飞 梁伟平 吕毛古[2] 王旭平 吴麟 缪东生 罗伟 

机构地区：[1]解放军81医院耳鼻咽喉科南京军区鼾症中心,江苏南京210002 [2]解放军81医院影像科,江苏南京210002

出　　处：《东南国防医药》2011年第6期494-496,共3页Military Medical Journal of Southeast China

基　　金：南京军区医学科技创新资助项目(08MA05110MA047)

摘　　要：目的研究睡眠监测阻塞定位仪(Apneagraphy,AG200)结合螺旋CT在评估阻塞性睡眠呼吸暂停低通气综合征(OSAHS)上气道狭窄中的临床应用价值。方法 28例睡眠打鼾患者,采用睡眠监测阻塞定位仪进行整夜睡眠呼吸监测,分析呼吸紊乱指标、出现呼吸暂停低通气事件时的阻塞平面,不同平面的阻塞次数和总阻塞次数。以螺旋CT测量清醒状态下上气道的软腭后区、舌后区气道的横截面积。将AG200测定上气道狭窄平面与CT测量判断平面进行比较。结果①28例AG200监测,6例排除OSAHS。22例符合OSAHS,其中轻度4例,中度10例,重度8例。②28例CT测量,4例无狭窄平面,16例腭后区狭窄2,例舌后区狭窄6,例腭后区、舌后区双重狭窄。③22例OSAHS中AG200测压均为上部和下部联合阻塞,上部阻塞为主18例,下部阻塞为主4例,其中1例上部阻塞为100%。④22例OSAHS中,AG200测压腭后区阻塞为主占81.8%(18/22),CT测量腭后区狭窄占68.2%(15/22),差异无统计学意义(P>0.05)。AG200测压下部阻塞为主占27.6%(6/22),CT测量舌后区阻塞占18.2%。结论 AG200对OSAHS定性定位诊断具有重要作用,结合CT测量可以很好地评估上气道腭后区狭窄。Objective To evaluate the clinical value of Apneagraph（AG200） and CT measurement in diagnosing obstructive sleep apnea hypopnea syndrome.Methods Twenty-eight snoring patients underwent one-night pressure monitoring by AG200 to measure the apnea hypopnea index（AHI）,the site of upper airway collapse and the obstructive proportion of different level.The upper airway levels from the roof of nasopharynx to the inferior border of annular cartilage were scanned by spiral CT to calculate the areas of retropalatal and retroglossal space using image handling workstation.The obstruction level found in CT screening and determined by pressure monitored were compared.Results ① In 28 snoring cases,OSAHS was excluded in 6 and 22 were confirmed as OSAHS,of which including 4 mild,10 moderate and 8 severe.② In 28 upper airway CT screening,no obstruction area were found in 4 cases.16 patients in retropalatal and 2 patients in retroglossal area occurred obstruction respectively.In 6 cases,the obstruction was found in both retropalatal and retroglossal area.③ 22 OSAHS cases had obstruction pattern of upper and lower level obstruction,of which 18 mainly at upper level（one was totally at upper level） and 4 mainly at lower level.④ In 22 OSAHS cases,the obstruction mainly in retropalatal area was found in 18 cases by AG200 and in 15 cases by CT.There was no difference between two methods.The obstruction mainly in retroglossal area was found in 4 cases by AG200 and in 6 cases by CT.Conclusion Apneagraph can serve as a useful device to diagnose sleep disordered breathing.It is beneficial for evaluating upper airway obstruction combining with CT.

关 键 词：睡眠呼吸暂停 阻塞性 上气道测压法 多导睡眠描记术 体层摄影术 X线计算机 

分 类 号：R768.1[医药卫生—耳鼻咽喉科]