利用MDCT上气道成像研究成人OSAHS疾病成因及应用价值  

The causes and application value of adult OSAHS by MDCT upper airway imaging

作　　者：杜雅青 马云霞[2] 王侠[1] 高照 宋建[1] 吴静[2] 吴开乐[2] 吴兴旺[1] Du Yaqing;Ma Yunxia;Wang Xia;Gao Zhao;Song Jian;Wu Jing;Wu Kaile;Wu Xingwang(Dept of Radiology,the First Affiliated Hospital of Anhui Medical University,Hefei 230001;Dept of Otolaryngology,the First Affiliated Hospital of Anhui Medical University,Hefei 230001)

机构地区：[1]安徽医科大学第一附属医院放射科,合肥230001 [2]安徽医科大学第一附属医院耳鼻喉科,合肥230001

出　　处：《安徽医科大学学报》2023年第3期500-505,共6页Acta Universitatis Medicinalis Anhui

基　　金：安徽省自然科学基金(编号:1808085MH252)。

摘　　要：目的评估多排CT(MDCT)上气道成像对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的诊断以及确定上气道阻塞部位中的价值。方法使用MDCT对临床确诊的85例不同程度OSAHS成人患者(男性73例,女性12例)在平静呼吸相、用力吸气相及60例正常成人(男性50例,女性10例)在平静呼吸相的上气道进行扫描,获得鼻腔、鼻咽、腭咽及舌咽容积;并对OSAHS患者及正常者咽旁脂肪体积进行测量;另记录所有OSAHS患者与疾病相关的三组临床数据,包括睡眠呼吸暂停低通气指数(AHI)、体质量指数(BMI)及最低血氧饱和度(LaSO_(2));最后对各组测量所得数据及临床数据进行统计分析。结果平静呼吸相实验组鼻咽部及腭咽部容积显著小于对照组;实验组腭咽部容积用力吸气相显著小于平静呼吸相;实验组咽旁脂肪体积显著大于对照组;AHI分别与BMI、咽旁脂肪体积具有一定正相关性;LaSO_(2)分别与AHI、BMI具有一定负相关性。结论OSAHS患者与正常者在解剖层面的显著差异性使得MDCT上气道成像在OSAHS疾病的诊断、治疗方面有很好的临床应用价值。Objective To evaluate the value of multi-detector CT(MDCT)upper airway imaging in the diagnosis of obstructive sleep apnea hypopnea syndrome(OSAHS)and in determining the location of upper airway obstruction.Methods MDCT was used to scan the upper airways of 85 clinically confirmed adult patients with different degrees of OSAHS(73 males and 12 females)in calm breathing phase and forced inhalation phase and 60 normal adults(50 males and 10 females)in calm breathing phase to obtain nasal cavity,nasopharynx,palatopharynx and oglosopharynx volumes.Parapharyngeal fat volume was measured in OSAHS patients and normal subjects.In addition,three groups of clinical data related to OSAHS patients were recorded,including sleep apnea hypopnea index(AHI),body mass index(BMI)and lowest blood oxygen saturation(LaSO_(2)).Finally,the measured data and clinical data of each group were statistically analyzed.Results The volume of nasopharynx and palatopharynx in the calm breathing group was significantly smaller than that in the control group,with statistical significance.Palatopharyngeal volume forced inspiratory phase was significantly smaller than calm breathing phase in the experimental group.The parapharyngeal fat volume in the experimental group was significantly higher than that in the control group.AHI was positively correlated with BMI and parapharyngeal fat volume.LaSO_(2) was negatively correlated with AHI and BMI,respectively.Conclusion MDCT upper airway imaging has good clinical application value in the diagnosis,treatment and postoperative evaluation of OSAHS disease due to the significant anatomical difference between OSAHS patients and normal subjects.

关 键 词：多排CT 阻塞性睡眠呼吸暂停低通气综合征 上气道容积 咽旁间隙 肥胖 

分 类 号：R445.3[医药卫生—影像医学与核医学]