舌骨位置与舌后气道最小截面积及阻塞性睡眠呼吸暂停低通气综合征严重程度的相关性分析  

Correlation of hyoid position,minimal retroglossal cross-section area and severity of obstructive sleep apnea hypopnea syndrome

作　　者：马国伟[1] 张庆泉[2] 周文亮[1] 

机构地区：[1]淄博市临淄区人民医院耳鼻咽喉科,山东淄博255400 [2]青岛大学附属烟台毓璜顶医院耳鼻咽喉头颈外科,山东烟台264000

出　　处：《山东大学耳鼻喉眼学报》2013年第6期66-68,71,共4页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者舌骨位置与舌后气道最小截面积及疾病严重程度的相关性。方法经多道睡眠监测(Polysomnography,PSG)确诊的成人OSAHS患者57例,以呼吸暂停低通气指数(AHI)作为病情严重程度的指标。取仰卧、法兰克福平面(FH)垂直于地面体位,平静呼吸时行上气道64排CT扫描。应用计算机三维重建技术,重建矢状位及横断位图像。通过矢状位图像,测量舌骨与下颌平面的夹角α,并以其作为反映舌骨上下位置的指标;测量舌骨与下颌骨前后距离的比值R,并以其作为反映舌骨前后位置的指标。通过横断位图像,测量舌后气道截面积s。应用统计分析软件将代表舌骨位置的指标α、R与舌后气道最小截面积s以及AHI等指标分别进行相关性分析。结果 57例中,舌骨下颌平面夹角α与AHI呈正相关(R=0.305,P=0.021);舌骨与下颌骨前后距离比值R与AHI无相关。反映舌骨位置的指标α、R均与舌后气道截面积s无相关。结论随着OSAHS患者病情的加重,舌骨位置表现为下移的趋势。OSAHS患者口底区域的脂肪等软组织的堆积挤压、颏舌肌等舌骨相关肌肉的功能减退为舌骨位置下移的可能原因。但是,在自然状态下,OSAHS患者舌骨位置的改变,并不会导致舌后气道截面积的改变。Objective To assess the correlation of hyoid position, minimal section area of retroglossal space and severity of patients with obstructive sleep apnea hypopnea syndrome （ OSAHS ）. Methods 57 adult OSAHS patients, diag- nosed by polysomnography （PSG）, were included in the study, and the apnea-hypopnea index （AHI） was used as an indicator for the severity of OSAHS. All the patients underwent upper airway 64-row CT scanning in supine and FH per- pendicular to the ground position. The computerized 3D reconstruction technique was used to reconstruct the sagittal and axial images. With the help of sagittal images, the angle between the hyoid bone and mandibular planes （a） was meas- ured and used as the indicator for the vertical position of the hyoid bone ; Meanwhile, the ratio （R） of hyoid-anterior mandible distance to hyoid-posterior mandible distance was measured and used as the indicator of the anteroposterior po- sition of the hyoid bone. With the help of axial images, the sectional area （s） of the retroglossal space was measured. The correlation of such indexes as, R, s, as well as AHI were analyzed by SPSS. Results In 57 cases, a positively correlated with AHI （R = 0. 305, P = 0. 021 ）. There was no correlation between AHI and R . Both et and R didn＇t show any correlation with s. Conclusion In OSAHS patients, the severity of the disease is related to the position of the hyoid bone. With the advancement of OSAHS, the position of the hyoid tends to move downwardly. The possible causes could be the aggregation of soft tissues, such as fat and etc. , at the mouth floor and the hypofunction of muscles related to the hyoid. But, under its natural condition, the change of the hyoid position in OSAHS patient would not lead to the transformation of the sectional area of the retroglossal space.

关 键 词：睡眠呼吸暂停 阻塞性 舌骨 体层摄影术 计算机 

分 类 号：R766.7[医药卫生—耳鼻咽喉科]