上呼吸道形态功能与阻塞性睡眠呼吸暂停综合征关系的病例对照研究

目的 对阻塞性睡眠呼吸暂停综合征（OSAS）患者和正常人上呼吸道的形态功能测量资料进行单因素对比研究和Logistic多元回归分析，了解对OSAS发病影响显著的因素。方法 经多导睡眠监测（PSG）确诊的OSAS患者共59例，年龄，性别相近的健康成年人57名，首先对两组上呼吸道的形态功能参数进行单因素对比研究，然后以受试者是否为OSAS患者为因变量，以一般临床资料处呼吸道的形态功能指标为自变量，进行Logistic多元回归分析。结果 绝大多数上呼吸道的形态功能指标在两组间的单因素对比中差异有显著性，Logistic回归分析从中找出影响显著的因素8个，结合赋仿方法，这些因素对OSAS发病的影响可以解释为；悬雍垂后区上呼吸道咽壁顺应性增强，软腭后区和悬雍垂后区上呼吸道咽后壁软组织增厚，颏舌肌宽度增加者发生OSAS的可能性增大，软腭后区上呼吸道横截面积减小，悬雍垂后区上呼吸道的冠状径和矢状径减小，舌后区上呼吸道冠状径减小者发生OSAS的可能性增加。结论 OSAS的发病受多种因素的影响，软腭后区，悬雍垂后区和舌后区的解剖性狭窄和悬雍垂后区咽壁顺应性增强是OSAS发病的主要因素。

A controlled study of the upper airway structure and function in patients with obstructive sleep apnea syndrome and normal adults

Objective To investigate the major factors associated with the development of obstructive sleep apnea syndrome (OSAS) by logistic step regression analysis.Method Fifty nine patients with OSAS and 57 normal adults were included in the study. The dependent was whether the subject had OSAS, and the independents included age, sex, body mass index (BMI), as well as the measured data of palate, uvula, lingua and epiglottis by CT scan. Logistic regression was performed by using SPSS software. Results Among 40 independents, 8 were chosen by logistic regression as the major factors associated with the risk of developing OSAS. These factors were the increase of pharyngeal wall resilience in the uvula region, the thickness of the retropharyngeal soft tissue in the uvula and palate region, the increase of genioglossus width, the decrease of cross section of the palate region , the decrease of the coronal diameter of the uvula and lingual region, and a narrowed diameter of the uvula region .Conclusion The results suggest that anatomic changes of the upper airway at different levels and an increase of the pharyngeal wall resilience in the uvula region are major etiological factors for OSAS.