联合应用腺样体与上气道形态预测儿童阻塞性睡眠呼吸暂停综合征  

Combination of adenoid and upper airway morphology in predicting obstructive sleep apnea hypopnea syndrome in children

作　　者：师炎敏 裴晓婷 常亚莞 肖新广 李润涛 吴春燕 张明 李艺 魏贵 杨培 SHI Yanmin;PEI Xiaoting;CHAGN Yawan;XIAO Xinguang;LI Runtao;WU Chunyan;ZHANG Ming;LI Yi;WEI Gui;YANG Pei(Department of Radiology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China;Henan Key Laboratory of Ophthalmology and Visual Science,Henan Eye Institute,Henan Provincial Eye Hospital and Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州大学附属郑州中心医院放射科,河南郑州450007 [2]河南省人民医院,河南省立眼科医院,河南省眼科研究所河南省眼科学与视觉科学重点实验室,河南郑州450003

出　　处：《中国医学影像技术》2020年第7期1007-1011,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的分析腺样体及上气道形态与儿童阻塞性睡眠呼吸暂停综合征(OSAHS)的关系,评估其联合预测OSAHS的效能。方法收集109名接受鼻咽部CT容积扫描1~10岁儿童,根据是否存在OSAHS分为OSAHS组(n=20)和非OSAHS组(n=89)。对所有CT图像进行三维重建,评估腺样体形态、大小及上气道形态(包括鼻咽腔容积、鼻间隙、气道最狭窄处面积及上下径和左右径),比较组间腺样体形态及大小、上气道形态差异,分析其与OSAHS的关系,评估其联合预测OSAHS的效能。结果鼻咽腔容积、鼻间隙、上气道最狭窄处面积及其上下径和左右径组间差异均有统计学意义(t=2.07、4.55、3.96、3.62、3.48,P均<0.05);腺样体肥大及腺样体形态组间差异均有统计学意义(χ^2=24.43、12.94,P均<0.05)。鼻间隙和气道最狭窄处面积及左右径较小者更易发生腺样体肥大和OSAHS;腺样体肥大是发生OSAHS的危险因素。联合应用腺样体与上气道形态预测OSAHS的AUC、敏感度、特异度及准确率分别为0.91、90.00%、79.78%及81.65%。结论腺样体肥大是OSAHS的危险因素;联合应用腺样体与上气道形态预测儿童OSAHS效能较佳。Objective To analyze the relationship of adenoid and upper airway morphology with obstructive sleep apnea hypopnea syndrome(OSAHS)in children,and to observe the efficacy of predicting OSAHS.Methods Totally 109 children aged 1-10 years who received nasopharyngeal CT volume scanning were enrolled and divided into OSAHS group(n=20)and non-OSAHS group(n=89).After 3D reconstruction of all CT images,the shape and size of adenoid and the morphology of upper airway(including nasopharyngeal volume,nasal space,airway narrowest area,upper and lower diameter as well as left and right diameter)were evaluated.The shape and size of adenoid and the morphology of upper airway were compared between 2 groups,the relationships with OSAHS were analyzed,and the efficacy of combination of which for predicting OSAHS were evaluated.Results Statistical differences of nasopharyngeal volume,nasal space,upper airway narrowest area,upper and lower diameters and left and right diameters(t=2.07,4.55,3.96,3.62,3.48,all P<0.05),also of adenoid hypertrophy and adenoid morphology(χ2=24.43,12.94,both P<0.05)were found between 2 groups.Adenoid hypertrophy and OSAHS were more likely to occur in children with smaller nasal space,airway narrowest area and left and right diameter.Adenoid hypertrophy was a risk factor for OSAHS.The AUC,sensitivity,specificity and accuracy of combination of adenoid and upper airway morphology in prediction of OSAHS was 0.91,90.00%,79.78%and 81.65%,respectively.Conclusion Adenoid hypertrophy is a risk factor of OSAHS.Combination of adenoid and upper airway morphology has good efficacy for predicting OSAHS in children.

关 键 词：鼻咽疾病 睡眠呼吸暂停 阻塞性 儿童 体层摄影术 X线计算机 

分 类 号：R766[医药卫生—耳鼻咽喉科] R445.3[医药卫生—临床医学]