非结构因素所致的阻塞性睡眠呼吸暂停低通气综合征患者咽壁松弛度的研究  

Study on pharyngeal wall floppiness of patients with obstructive sleep apnea-hypopnea syndrome attributable to non-structural factors

作　　者：林志强[1] 蒋康伦[2] 赵琳[2] 李姝娜[2] 邵舒 钱炜[2] 陶泽璋[1] 

机构地区：[1]武汉大学人民医院耳鼻咽喉头颈外科,430060 [2]江苏大学附属人民医院耳鼻咽喉头颈外科,镇江212002

出　　处：《中华耳鼻咽喉头颈外科杂志》2017年第9期676-680,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的 采用咽声反射技术定量评估非上气道结构因素所致阻塞性睡眠呼吸暂停综合征（OSAHS）患者与正常人咽壁松弛度（pharyngeal wall floppiness,PWF）的改变及其临床意义.方法采用Ecconvision型咽声反射测量仪,对纳入研究的102例非结构因素所致OSAHS男性患者及50名健康男性对照组进行检测,分别记录其坐、卧位呼气与吸气状态时咽腔容积,计算坐、卧位状态下PWF,并应用SPSS 12.0软件进行统计学分析.结果 OSAHS组坐位PWF为0.14±0.09,卧位PWF为0.21±0.10,均显著高于对照组（t=5.96,t=9.63,P〈0.001）.OSAHS组与对照组卧位PWF均显著高于坐位PWF（t=-11.91,P〈0.001;t=-2.32,P=0.025）.OSAHS组ΔPWF（PWF卧位-PWF坐位）为0.063±0.054,显著高于对照组（F=41.173,P〈0.01）.坐位与卧位PWF均与年龄正相关（r=0.714,r=0.735,P〈0.001）,与体质量指数无关（P〉0.05）.结论 PWF可以作为反映上气道生理特征的一个指标,卧位状态下检测PWF更加准确地反映OSAHS患者的气道易塌陷特征.以PWF升高为量化的咽壁松弛是OSAHS患者发病的重要非结构因素,可能为我们临床实践中制定OSAHS个性化治疗方案起到指导作用.Objective Acoustic pharyngealmetry technology is utilized to evaluate the change and clinical significance of obstructive sleep apnea-hypopnea syndrome （OSAHS） patients caused by non-upper airway structural factor and normal individuals＆#39; PWF（pharyngeal wall floppiness）.Methods Acoustic pharyngealmetry instrument of Ecconvision was utilized to examine 102 OSAHS patients and 50 normal individuals,separately recorded their volume of pharyngeal cavity in sit or supine position,calculated PWF in sit or supine position,and SPSS 12.0 of tware was used to analyze data.Results PWF was 0.14±0.09 in sit position and PWF was 0.21±0.10,（t=5.96,t=9.63,P〈0.001）in supine position of OSAHS group,which were all significantly higher than those of control group.PWFs in supine position of OSAHS group and control group were evidently higher than PWF（t=-11.91,P〈0.001;t=-2.32,P=0.025） in sit position.ΔPWF（PWF_supine-PWF_sit）was 0.063±0.054 in OSAHS group which was significantly greater than in control（F=41.173,P〈0.01）.PWF in sit position and supine position were all positively related with age（r=0.714,r=0.735,P〈0.001）while irrelevant with BMI（P〉0.05）.ConclusionsPWF can be utilized to be an index to reflect the physiological feature of upper airway.PWF can more precisely reflect upper airway collapsibility of OSAHS patients on the condition of PWF in supine position.Pharyngeal wall floppiness quantified as a high PWF index is a non-structure vital factor of OSAHS patients and plays a role of guiding us to make personal treatment plans for OSAHS patients.

关 键 词：睡眠呼吸暂停 阻塞性 咽 

分 类 号：R766[医药卫生—耳鼻咽喉科]