儿童与成年不同骨面型正畸患者扁桃体肥大率初探  

Percentage of tonsil hypertrophy in orthodontic patients with different sagittal skeletal relationship

作　　者：赵婷婷 王敏[2] 杨郑 张俊[3] 花放 贺红[2] Zhao Tingting;Wang Min;Yang Zheng;Zhang Jun;Hua Fang;He Hong(The State Key Laboratory Breeding Base of Basic Science of Stomatology&Key Laboratory of Oral Biomedicine Ministry of Education,School of Stomatology,Wuhan University,Wuhan 430079,China;Department of Orthodontics Division 1,School of Stomatology,Wuhan University,Wuhan 430079,China;Department of Radiology,School of Stomatology,Wuhan University,Wuhan 430079,China)

机构地区：[1]武汉大学口腔医学院口腔基础医学省部共建国家重点实验室培育基地和口腔生物医学教育部重点实验室,武汉430079 [2]武汉大学口腔医学院口腔正畸一科,武汉430079 [3]武汉大学口腔医学院放射科,武汉430079

出　　处：《中华口腔医学杂志》2022年第3期266-271,共6页Chinese Journal of Stomatology

基　　金：中华口腔医学会中西部口腔正畸临床研究项目(CSA-MWO2021-01)。

摘　　要：目的调查儿童与成年不同骨面型正畸患者的扁桃体肥大率,探讨扁桃体肥大是否与特定骨面型的发生相关,以期为扁桃体肥大伴错畸形的早期干预提供参考。方法回顾性收集2019年1至8月就诊于武汉大学口腔医学院正畸一科的正畸患者初诊头颅侧位X线片,根据患者年龄分为儿童组(年龄≥6岁且≤12岁)和成人组(年龄≥18岁),再根据ANB角(上牙槽座点、鼻根点与下牙槽座点构成的角)分为3类:Ⅰ类骨面型(ANB角≥0°且≤4°)、Ⅱ类骨面型(ANB角>4°)及Ⅲ类骨面型(ANB角<0°)。由2名经过专门培训的口腔正畸专业主治医师,根据Baroni法在头颅侧位X线片上测量扁桃体阻塞口咽气道的情况,以此判断患者是否存在扁桃体肥大。采用Bonferroni校正χ^(2)检验比较不同骨面型扁桃体肥大率的差异(α=0.017)。结果最终纳入1776例正畸患者的头颅侧位X线片,其中儿童组593例,成人组1183例;Ⅰ类骨面型占37.8%(672/1776),Ⅱ类骨面型占47.8%(849/1776),Ⅲ类骨面型占14.4%(255/1776)。儿童组扁桃体肥大率为66.3%(393/593),其中Ⅲ类骨面型扁桃体肥大率[87.0%(60/69)]显著大于Ⅰ类和Ⅱ类骨面型[分别为65.6%(145/221)和62.0%(188/303)](χ^(2)=11.56和15.69,P<0.017)。成人组扁桃体肥大率为23.2%(275/1183),其中Ⅲ类骨面型扁桃体肥大率[42.5%(79/186)]显著大于Ⅰ类和Ⅱ类骨面型[分别为19.1%(86/451)和20.2%(110/546)](χ^(2)=36.50和35.00,P<0.017)。儿童组或成人组的Ⅰ类与Ⅱ类骨面型扁桃体肥大率差异均无统计学意义(χ^(2)=0.70和0.18,P>0.017)。结论儿童与成年Ⅲ类骨面型正畸患者的扁桃体肥大率均显著大于对应人群Ⅰ类及Ⅱ类骨面型,扁桃体肥大可能是Ⅲ类骨面型发生的重要危险因素之一。Objective To investigate the prevalence of tonsil hypertrophy in patients with different sagittal skeletal craniofacial patterns,as well as the correlation between tonsil hypertrophy and the type of skeletal pattern.Methods Lateral cephalograms of patients who visited the Department of Orthodontics Division 1,School of Stomatology,Wuhan University during January to August,2019 were retrospectively collected.Patients(children:age≥6 and≤12 year;adults:age≥18 year)were divided into three groups according to the ANB(subspinale-nasion-supramental)angle:the skeletal classⅠgroup(0°≤ANB≤4°),skeletal classⅡgroup(ANB>4°)and skeletal classⅢgroup(ANB<0°).Tonsil hypertrophy was diagnosed with lateral cephalogram by two specifically trained orthodontists independently,according to the Baroni′s method.The between-group differences in tonsil hypertrophy prevalence were analyzed using chi-square tests with Bonferroni correction(α=0.017).Results A total of 1776 patients(593 children and 1183 adults)were included,among which 672(37.8%)were with classⅠ,849(47.8%)with classⅡ,and 255(14.4%)with classⅢskeletal pattern.The prevalence of tonsil hypertrophy in children was 66.3%(393/593).The proportion of children with tonsil hypertrophy in classⅢgroup[87.0%(60/69)]were significantly higher than that in classⅠ[65.6%(145/221),χ^(2)=11.56,P<0.017]and classⅡ[62.0%(188/303),χ^(2)=15.69,P<0.017]groups.The prevalence of tonsil hypertrophy in adults was 23.2%(275/1183).The proportion of adults with tonsil hypertrophy in classⅢgroup[42.5%(79/186)]was significantly higher than that in classⅠ[19.1%(86/451),χ^(2)=36.50,P<0.017]and classⅡ[20.2%(110/546),χ^(2)=35.00,P<0.017]groups.However,there was no significant difference in the prevalence of tonsil hypertrophy between classⅠand classⅡgroups for both children(χ^(2)=0.70,P>0.017)and adults(χ^(2)=0.18,P>0.017).Conclusions The prevalence of tonsil hypertrophy in skeletal classⅢpatients was significantly higher than that in patients with skeletal clas

关 键 词：腭扁桃体 错 安氏Ⅲ类 正畸学 横断面研究 扁桃体肥大 

分 类 号：R783.5[医药卫生—口腔医学]