8～13岁中国健康儿童鼻咽部生长发育变化的纵向研究  

Nasopharyngeal changes in 8-13 years old healthy children in China： a longitudinal study

作　　者：刘杉杉[1] 邓金荣[1] 王东升[2] 弓煦[1] 周彦恒[1] 高雪梅[1] 

机构地区：[1]100081 北京大学口腔医院及医学院正畸科,口腔数字化医疗技术和材料国家工程实验室,口腔数字医学北京市重点实验室,100081 [2]清华大学玉泉医院放射科,北京100040

出　　处：《中华耳鼻咽喉头颈外科杂志》2016年第10期733-739,共7页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：基金项目：国家自然科学基金（30872915、81470272）

摘　　要：目的 探索儿童生长发育快速期的鼻咽部变化特点.方法 通过综合问卷、临床检查等方式筛选出8 ～11岁无鼾儿童30名,每年进行MRI检查测量鼻咽部变化,进行头影测量观察颅面部发育,并进行整夜多道睡眠监测,23名儿童连续追踪3年,5名儿童连续追踪2年,共形成51个8～13岁组的混合纵向样本.对鼻咽部指标的年变化量进行方差分析,对其颅面影响因素进行相关分析.结果 8～10岁是鼻咽部的快速生长发育期,此时鼻咽横径发育较快,鼻咽矢状径的快速发育期约于12～13岁出现.鼻咽部生长呈现持续性.鼻咽部截面积的变化量与舌咽区段升支距离、舌骨-前颈椎平面距离、舌咽区段咽前径的变化量呈正相关（r值分别为0.363、0.363、0.323,P值均＜0.05）;鼻咽部体积的变化量与鼻根点-前鼻棘点间的垂直距离、舌咽区段升支距离、舌咽区段咽前径的变化量呈正相关（r值分别为0.336、0.413、0.478,P值均＜0.05）;鼻咽部矢状径的变化量与鼻根点-下齿槽座点连线与前颅底平面的交角呈负相关（r=-0.322,P＜0.05）;鼻咽部横径的变化量与腺样体最突出矢状长度变化量呈负相关（r=-0.411,P＜0.01）.结论 鼻咽部发育较早且持续,上下颌骨的发育均可以影响高位上气道的形态.Objective Nasopharynx is an important compartment of the upper airway.It is closely associated with the characteristic craniofacial skeletal pattern related to sleep breathing.The present study aimed to investigate the growth pattern of the nasopharynx during rapid puberty growth period.Methods Thirty non-snoring children （aged 8 to l 1 years old） were selected by means of questionnaires and clinical examination.Periodic yearly follow up using MRI,lateral cephalogram,and polysomnograph （PSG） was done in these children.Fifty-one final mixed longitudinal samples were consisted of 23 children completed three consecutive follow-up,and 5 children completed two consecutive follow-up.The yearly changes of the nasopharynx and craniofacial structures were measured.ANOVA was used to evaluate the yearly growth of the nasopharynx.Correlated analysis was used to explore the potential influencing factors of craniofacial structures.Results The rapid growth period of the nasopharynx located in the age range of 8-10 years old,during which the transverse dimension of the nasopharynx developed rapidly,while the rapid development of the sagittal dimension of the nasopharynx was around 12-13 years old.The growth of the nasopharynx was continuous.The changes in the cross-sectional area of the nasopharynx （⊿ CSA） was positively correlated with the changes in distance between mandible of glossopharyngeus （⊿ M）,distance of hyoid to cervical anterior surface （⊿ H-CVP）,and anterior pharyngeal distance of glossopharyngeus （⊿ AD） （r =0.363,0.363,0.323,respectively,all P 〈 0.05）.The changes in the volume of the nasopharynx （⊿ V） was positively correlated with the changes in upper facial height （⊿ N-ANS）,⊿ M,and ⊿ AD （r =0.336,0.413,0.478,respectively,all P 〈 0.05）.The changes in the sagittal dimension of the nasopharynx （⊿ S） was negatively correlated with angulation in supramental and anatomical horizontal line （⊿ SNB） （r =-0.322,P =0.045）.The changes in the transver

关 键 词：鼻咽 儿童发育 上颌面部发育 纵向研究 

分 类 号：R339.31[医药卫生—人体生理学]