山东大学耳鼻喉眼学报 ›› 2016, Vol. 30 ›› Issue (5): 24-28.doi: 10.6040/j.issn.1673-3770.0.2016.234

• 睡眠呼吸障碍性疾病 • 上一篇    下一篇

阻塞性睡眠呼吸暂停低通气综合征患者腭舌比值与症状程度的相关性分析

史春海1,商晓敏2,刘富超3,唐维维3,黑任轶3,李树华3   

  1. 1.锦州医科大学沈阳军区总医院研究生培养基地, 辽宁 沈阳 110840;
    2.沈阳市中医药学校, 辽宁 沈阳 110016;
    3.沈阳军区总医院耳鼻咽喉-头颈外科, 辽宁 沈阳 110840
  • 收稿日期:2016-05-25 出版日期:2016-10-20 发布日期:2016-10-20
  • 通讯作者: 李树华. E-mail:lishsy@sina.com E-mail:daxia3.4@163.co
  • 作者简介:史春海. E-mail:daxia3.4@163.co
  • 基金资助:
    辽宁省自然科学基金(2015020441)

The correlation analysis between the ratio of palate tongue and symptom in patients with obstructive sleep apnea hypopnea syndrome.

SHI Chunhai1, SHANG Xiaomin2, LIU Fuchao3, TANG Weiwei3, HEI Renyi3, LI Shuhua   

  1. 1. General Hospital of Shenyang Military Area Command, Postgraduate Culture base of Jin Zhou Medical University, Shenyang 110840, Liaoning, China;2. Shenyang Traditional Chinese Medicine School Shenyang 110840, Liaoning, China;3. Department of Otolaryngology &Head and Neck Surgery, General Hospital of Shenyang Military Area Command, Shenyang 110840, Liaoning, China
  • Received:2016-05-25 Online:2016-10-20 Published:2016-10-20

HTML

PDF (PC)

712

摘要： 目的 探讨软腭长度与舌体厚度比值的大小和阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者症状轻重高低的关系,并与传统Friedman分型比较。 方法 纳入研究的OSAHS患者110名,均采用螺旋CT自前颅底至甲状软骨水平区域进行连续扫描,选取硬腭正中矢状位三维重建图像分析,应用计算机辅助测图工具测量硬腭后缘至悬雍垂尖端长度,以及颏嵴至舌中后1/3交接点(即舌盲孔处)舌体厚度,并计算软腭长度与舌体厚度比值。分析该比值与多导睡眠呼吸监测(PSG)检查结果的关系,并与Friedman分型比较。 结果 (1)软腭长度与舌体厚度比值与OSAHS病情严重程度低通气指数(AHI)数值呈显著正相关(r=0.313, P=0.001);与Friedman分型呈负相关(r=-0.196, P=0.041);(2)在不同AHI分度组间比较,软腭长度与舌体厚度比值有显著差异(F=3.478, P=0.019);(3)在不同Friedman分型组间比较,软腭长度与舌体厚度比值有显著差异(t=2.131, P=0.035)。(4)多元逐步回归分析证实软腭长度与舌体厚度比值是AHI大小的显著影响因素(R=0.265, F=19.333, P=0.001)。 结论 OSAHS患者AHI与软腭长度与舌体厚度的比值呈明显正相关性,即随软腭长度与舌体厚度的比值增大,OSAHS病情严重程度也增加,同时其与传统Friedman分型有一定的一致性。

关键词: 体层摄影术,X线计算机, Friedman分型, 软腭长度, 睡眠呼吸暂停,阻塞性, 舌体厚度

Abstract: Objective To analyze the correlation between the palate/tongue(P/T)ratio and the severity of obstructive sleep apnea hypopnea syndrome(OSAHS)patients with symptoms of level, and make a comparison of P/T ratio with Friedman stage. Methods One hundred and ten patients with OSAHS who were referred to our hospital between December 2010 and August 2012, were enrolled in this study. Computed tomography(CT)scans were performed from the skull base to the thyroid cartilage, and the middle and sagittal reconstruction images of the pharyngeal region were obtained. The length of the soft palate means the distance from the base of the soft palate to the tip of the uvula, and the lingual thickness means the distance from the genial tubercle to the foramen cecum linguae. The P/T ratios of length of the soft palate to the lingual thickness were measured. Finally, we analyzed the correlation between P/T ratio and apnea hypopnea index(AHI)and compared the P/T ration and Friedman Stage. Results (1) The P/T ratio had significantly positive correlation with AHI(r=0.313, P=0.001)and had negative correlation with Friedman stage(r=-0.196, P=0.041). (2) The P/T ratios had significant differences among different severity OSAHS groups(F=3.478, P=0.019). (3) The P/T ratios had significant differences among different Friedman stage groups(t= 2.131, P=0.035). (4) The multinomial step regression analysis showed that the P/T ratios was the most important factor of AHI(R=0.265, F=19.333, P< 0.001). Conclusion The P/T ratio had significantly positive correlation with AHI in 山东大学耳鼻喉眼学报30卷5期 -史春海,等.阻塞性睡眠呼吸暂停低通气综合征患者腭舌比值与症状程度的相关性分析 \=-OSAHS patients. When P/T ratio increased, the severity of OSAHS also increased. Meanwhile, P/T ratio has a certain consistency with the Friedman stage.

Key words: Tongue thickness, Friedman stage, X-ray computed tomography, Obstructive sleep apnea and hypopnea syndrome, Length of the soft palate

中图分类号: 

  • R766.7
[1] 中华耳鼻咽喉头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉头颈外科学分会咽喉学组.阻塞性睡眠呼吸暂停低通气综合征诊断依据和外科治疗指南[J]. 中华耳鼻咽喉头颈外科杂志, 2009, 44(2): 95-96. Chinese magazine editor committee of otolaryngology head and neck surgery, Chinese medical association otolaryngology head and neck surgery branch of the throat group. Patients with obstructive sleep apnea hypopnea syndrome diagnosis and surgical treatment guidelines[J]. Chin J Otolaryngology Head Neck Surgery, 2009, 44(2):95-96.
[2] Owens R L, Eckert D J, Yeh S Y, et al. Upper airway function in the pathogenesis of obstructive sleep apnea: a review of the current literature[J]. Crux Opin Pulm Med, 2008, 14(6):519-524.
[3] Jordan A S, White D P. Pharyngeal motor control and the pathogenesis of obstructive sleep apnea[J]. Respir Physiol Neurobiol, 2008, 160(1):1-7.
[4] Verbraecken J A, De Backer W A. Upper airway mechanics[J]. Respiration, 2009, 78(2):121-133.
[5] 温伟生,胡敏,柳春明,等.不同体位下软腭位置与腭后气道的相关性研究[J].军医进修学院学报,2001,22(1):57-59. WEN Weisheng, HU Min, LIU Chunming, et al. Relationship between soft palate and retropatal airway in different posture[J]. Academic J Pla Postgraduate Med School, 2001, 22(1):57-59.
[6] Li S, Wu D, Bao J, et al. The nasopharyngeal tube: a simple and effective tool to indicate the need for uvulopalatopharyngoplasty[J]. Laryngoscope, 2014, 124(4):1023-1028.
[7] Li S, Wu D, Shi H. Treatment of obstructive sleep apnea hypopnea syndrome caused by glossoptosis with tongue-base suspension[J]. Eur Arch Otorhinolaryngol, 2013, 270(11):2915-2920.
[8] 陈刚,赵华,温妮热,等. 重度阻塞性睡眠呼吸暂停低通气综合征的同期多平面外科治疗[J]. 临床耳鼻咽喉头颈外科杂志,2011,25(9):392-395. CHEN Gang, ZHAO Hua, WEN Nire, et al. Simultaneous multiple plane operations in treating severe obstructive sleep apnea-hypopnea syndrome[J]. Chin Otorhinolaryngol Head Neek Surg(China), 2011, 25(9):392-395.
[9] 郭星,徐乐昕,李国栋,等. 多平面手术治疗阻塞性睡眠呼吸暂停低通气综合征疗效评价[J]. 中华耳鼻咽喉头颈外科杂志,2009,4(8):645-650. GUO Xing, XU Lexin, LI Guodong, et al. Effective evaluation of multiple level sugery in obstructive sleep apnea-hypopnea syndrome[J]. Chin J Otorhinolaryngol Head Neek Surg, 2009, 4(8):645-650.
[10] Low C, Young P, Webb C J, et al. A simpleand reliable predictor for an adequate laryngeal view with rigid endoscopic laryngoscopy[J]. Otolaryngol Head Neck Surg, 2005, 132(2):244-246.
[11] Friedman M, Ibrahim H, Joseph N J. Staging of obstructive sleep apnea/hypopnea syndrome: a guide to appropriate treatment[J]. Laryngoscope, 2004, 114(3):454-459.
[1] 孙晓强1，易红良2，曹振宇2，张玉君2. Friedman分型与ZPPP联合GAHM手术疗效的相关性分析[J]. 山东大学耳鼻喉眼学报, 2012, 26(6): 8-9.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发