上气道MSCT测量对中重度OSA成年男性患者的临床价值  

Clinical value of upper airway MSCT measurement in adult male patients with moderate to severe OSA

作　　者：郭晨 龙平[1] 叶菁[1] 李海军[2] GUO Chen;LONG Ping;YE Jing;LI Haijun(Department of Otolaryngology Head and Neck Surgery,the First Affiliated Hospital of Nanchang University,Nanchang,330006,China;Department of Imaging,the First Affiliated Hospital of Nanchang University)

机构地区：[1]南昌大学第一附属医院耳鼻咽喉头颈外科,南昌330006 [2]南昌大学第一附属医院影像科

出　　处：《临床耳鼻咽喉头颈外科杂志》2020年第9期814-819,共6页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:通过128层螺旋CT测量中重度阻塞性睡眠呼吸暂停(OSA)成年男性患者在不同呼吸时相上气道解剖结构的变化,探讨与OSA相关的发病机制,优化OSA患者的治疗选择。方法:应用128层螺旋CT对52例中重度OSA成年男性患者(OSA组)和20例正常对照组(正常组)分别在平静呼吸及Müller动作2种不同呼吸状态下进行上气道扫描,测量上气道各区域平面径线长度、面积大小,软腭长度、厚度、气道体积、气道长度、咽侧壁总厚度,并计算出咽腔顺应性包括咽侧壁顺应性、咽前后壁顺应性及总咽壁顺应性,将各测量结果进行相互比较并与相关参数进行相关性分析。结果:OSA组平静呼吸时气道各区(除会厌后区外)最小平面的径线长度及面积均显著大于Müller动作(P<0.05),OSA组平静呼吸时的软腭长度、厚度显著大于正常组(P<0.01),OSA组Müller动作软腭区和舌后区咽侧壁总厚度显著大于平静呼吸状态(P<0.01),OSA组平静呼吸时鼻咽区、会厌后区体积、气道长度显著大于正常组(P<0.01),OSA组Müller动作时软腭后区和舌后区体积以及气道总体积均显著小于平静呼吸状态(P<0.01),OSA组咽腔顺应性均显著大于正常组(P<0.05),OSA组软腭后区咽侧壁顺应性显著大于咽前后壁顺应性,而舌后区咽前后壁顺应性显著大于咽侧壁顺应性(P<0.05)。OSA患者的BMI与AHI呈正相关(P<0.05)。结论:通过MSCT对中重度OSA成年男性患者上气道的测量,能直观地观察上气道形态结构和顺应性的变化,精准评估上气道狭窄程度和狭窄部位,同时结合测量指标与相关参数的相关性能够优化临床上OSA成年男性患者的治疗选择。Objective:To investigate the pathogenesis of OSA-related through 128-slice spiral CT measurements of adult male patients with moderate to severe OSA at different respiratory phases,and to optimize treatment options for patients with OSA.Method:128-slice spiral CT was used to scan the upper airway in 52 adult male patients with moderate to severe OSA and 20 normal controls under two different breathing states:calm breathing and Müller maneuver.The plane diameter and length of each area of the upper airway were measured.Area size,soft palate length,thickness,airway volume,airway length,total thickness of the pharyngeal wall,and calculate the compliance of the pharyngeal cavity,including the compliance of the pharyngeal wall,the compliance of the anterior and posterior pharyngeal wall,and the total pharyngeal compliance.Comparison of measurement results and correlation analysis with related parameters.Result:In the OSA group,the length and area of the smallest plane of each airway area(except the posterior epiglottic area)during calm breathing are greater than Müller’s movement,and the difference was statistically significant(P<0.05).The soft palate length and thickness of the OSA group during calm breathing were significantly larger than those of the normal group,and the difference was statistically significant(P<0.01),In the OSA group,the total thickness of the soft palate region and the posterior lingual area of the pharyngeal wall in the Müller group was significantly greater than the calm breathing state,and the difference was statistically significant(P<0.01).The volume of the nasopharynx,posterior epiglottic area and airway length in the OSA group during calm breathing were significantly larger than those in the normal group,and the difference was statistically significant(P<0.01).The compliance of the pharyngeal cavity in the OSA group was greater than that in the normal group,and the difference was statistically significant(P<0.05).In the OSA group,the volume of the posterior soft palate,posterior tong

关 键 词：睡眠呼吸暂停 阻塞性 咽侧壁总厚度 成年男性 气道塌陷 

分 类 号：R766[医药卫生—耳鼻咽喉科]