呼吸运动周期中成人上呼吸道形态的动态观察

目的 观察正常人和阻塞性睡眠呼吸暂停综合征(Obstructive sleep apnea syncirome，OSAS)患者在呼吸运动周期中上呼吸道的形态学变化，比较正常人和OSAS患者间的差别。方法 经PSG确诊的OSAS患者共34人，年龄性别相近的正常成年人30人，以纤维内窥镜观察清醒平静呼吸时上呼吸道的形态变化，对受试者上呼吸道吸气和呼气时的形态分别拍照，利用计算机图像测量分析技术计算吸气和呼气之间上呼吸道形态学改变的幅度，比较正常人和OSAS患者间的差别。结果 正常人和OSAS患者，均表现为吸气时上呼吸道横截面积明显缩小，吸气中期达到最小，呼气开始则横截面积增大，呼气中期达到最大。OSAS患者在呼气和吸气间的改变幅度明显大于正常对照组，左右径的改变幅度大于前后径。软腭后区的改变幅度大于舌后区。结论 呼吸运动周期中上呼吸道的形态存在周期性的变化，OSAS患者的变化幅度明显大于正常对照者，这种较大的变化幅度是OSAS患者睡眠中发生上呼吸道阻塞的基础。

CHANGES OF UPPER AIRWAY WITH RESPIRATION IN NORMAL ADULTS AND OSAS PATIENTS

Objective:To explore the effects of quiet respiration on upper airway caliber in normal adult and OSAS patients and the difference of effects between normal adults and OSAS patients.Methods:Thirty-four patients with OSAS and 30 normal adults were included in the study. The fibre endoscopic photo were taken on palate and lingua region upper airway at inspiration and expiration in eupnea, respectively. The cross section area and the dimension of palate and lingua region upper airway was studied by running image tools software in computer, and the changes of areas and dimensions at palate and lingua region upper airway were calculated.Results:In OSAS patients and normal adults, the upper airway caliber decrease with inspiration begin and reach the most narrowing at the end of inspiration,and the upper airway caliber enlarges with expiration begin and reach the most widening at the end of expiration. There are obviously difference in the effects of respiration on upper airway caliber between normal adults and OSAS patients. The effects of inspiration on coronary dimension of upper airway are more obviously than that on arrowy dimension, and the effects of respiration on palate region is more obviously than that on lingua region.Conclusions:There are periodically changes of upper airway during respiration cycle in normal adults and OSAS patients. The effects of respiration on upper airway caliber of OSAS patients are more obviously than that of normal adults, and the increasing effects in OSAS patients is one of OSAS etiology.