口腔矫治器治疗阻塞性睡眠呼吸暂停综合征

目的探讨口腔矫治器对阻塞性睡眠呼吸暂停综合征(OSAS)患者的临床疗效.方法将32例OSAS患者分为轻中度组和重度组,分别制作"下颌前移型"口腔矫治器并在睡眠时配戴,用多导睡眠图监测患者治疗前后睡眠结构及呼吸功能的变化.结果使用口腔矫治器后轻中度组和重度组患者的呼吸暂停指数(AI)分别平均下降11.3次/小时(P＜0.001)和26.01次/小时(P＜0.001),最低SaO2分别平均升高3.65%(P＜0.01)和19.75秒(P＜0.05).结论口腔矫治器是治疗该病的一种有效的疗法.     

阻塞性睡眠呼吸暂停综合征患者颏舌肌肌电活性特征的研究

目的本研究旨在探讨GG与OSAS发病的关系.方法通过15名OSAS患者PSG和同步的GG、肌电图检查,对各睡眠阶段GG电活性的差异以及睡眠呼吸暂停发作过程中GG肌活性的变化进行分析.结果①OSAS患者清醒平静呼吸和睡眠平静呼吸阶段GG肌电水平无明显差异(P＞0.05),睡眠呼吸暂停发作阶段的GG肌电水平显著增高(P＜0.05);单纯鼾症患者各睡眠阶段之间GG肌电活性无差异(P＜0.05).②OSAS患者睡眠呼吸暂停时GG肌电活性波动幅度增大,呼吸暂停期内GG肌电活性比呼吸暂停期前减小,呼吸暂停缓解时GG肌电活性达到峰值,呼吸暂停期前、呼吸暂停和呼吸暂停期后这间GG肌电活性差异显著(P＜0.05).结论OSAS患者发生睡眠呼吸暂停时GG肌电活性代偿性增加,扩大上气道以缓解呼吸暂停.     

sALP、sNTX与下颌骨骨密度改变的相关性分析

目的:探讨下颌牙列缺损人群血清碱性磷酸酶(sALP)和Ⅰ型胶原氨基末端肽(sNTX)随年龄变化及其下颌骨PIM指数之间的关系.方法:选用下颌牙列缺损健康患者60例,年龄20～79岁,分成6个年龄段,10岁为一年龄段,其中男性40名、女性20名.全景曲面断层采用PMI指数测量受试者,同时抽取血清测试骨生化指标sALP和sNTX.根据测试数据进行分析.结果:PMI和sALP、sNTX的性别间比较:4个指标均未见具有统计学意义的性别差别.下颌骨密度指标和骨生化指标与年龄关系:下颌骨密度指标(sPMI、iPMI)与年龄呈高度负相关(r值为-0.845,-0.917,P＜0.001),骨生化指标(sALP、sNTX)与年龄呈正相关(r值为0.946,0.423,P＜0.001).sALP和sNTX在20～39岁年龄段较低,自40～49岁年龄段开始明显升高(P＜0.001),sPMI和iPMI在50～59岁年龄段较30～39岁之前年龄段显著下降(P＜0.001).结论:年龄是下颌骨密度指数和骨生化指标变化的重要因素;sALP和sNTX反映下颌骨高骨转换状态,是下颌骨量丢失的重要因素之一;sPMI和iPMI是反映下颌骨密度改变的敏感指标.     

人体体重指数、颈围及颅面与阻塞性睡眠呼吸暂停综合征的关系

目的研究阻塞性睡眠呼吸暂停综合生(OSAS)及鼾症患者人体体重指数、颈围、颅面结构特征与呼吸暂停及低通气指数(AHI)的关系.方法159名欧洲白种OSAS及鼾症患者.OSAS诊断标准为AHI＞次/小时,AHI≤15次/小时者为鼾症.每位患者拍摄自然头位X线头颅侧位片,临床检查(体重指数、颈围)及多导睡眠仪检查.患者又依体重指数(BMI)分组,BMI≤25为正常,BMI＞25为超重.统计分析为t检验,相关分析及多因素逐步回归.结果OSAS及鼾症患者之间的体重指数及颈围大小无显著性差异.男性OSAS患者的软腭长度大于鼾症者.相关分析结果为AHI与患者的颈围、体重指数、下颌位置、下颌平面角相关.多因素回归分析结果表明在超重OSAS患者中AHI与颈围及下颌平面角相关,而体重正常的OSAS患者,AHI与气道宽度、软腭长度相关.超重OSAS患者按性别分组后,男性组AHI与体重指数相关,女性组AHI与颈围大小相关.结论在OSAS与鼾症患者之间存在一些气道结构上的差异.男性、女性及超重、正常体重AHI的不同的相关关系表明,它们之间存在一些病理生理上的差异.     

伴牙周炎糖尿病患者血清和龈沟液中C反应蛋白的检测及意义

目的:了解龈沟液和血清中C反应蛋白(C-reactive protein,CRP)水平与牙周炎症状况、血糖控制情况的关系.方法:检测伴慢性牙周炎2型糖尿病组、慢性牙周炎组、2型糖尿病组和健康人群组血清和龈沟液中CRP浓度、糖化血红蛋(glycosylated hemoglobin,HbAlc)水平,记录牙周探诊深度(probing depth,PD)和龈沟出血指数(sulcus bleeding index,SBI).采用SPSS10.0软件包进行独立样本t检验和Spearman相关分析.结果:伴慢性牙周炎2型糖尿病组、慢性牙周炎组、2型糖尿病组血清CRP均比正常对照组显著升高(P＜0.01),且伴慢性牙周炎2型糖尿病组血清CRP水平最高,显著高于慢性牙周炎组(P＜0.01)和2型糖尿病组(P＜0.05);4组的龈沟液CRP水平均远低于血清水平,且4组间无显著差异(P＞0.05);血清CRP与龈沟液CRP无相关性(P＞0.05);血清CRP与PD、SBI和HbAlc显著相关(P＜0.01).结论:CRP可能参与了牙周炎和2型糖尿病之间的互相影响;龈沟液CRP水平不能反映牙周病炎症程度和糖尿病病情.     

非硝苯地平钙离子拮抗剂与牙龈增生的关系研究

目的:探讨服用非硝苯地平的钙离子拮抗剂(除硝苯地平之外的其他钙离子拮抗剂)与牙龈增生的关系.方法:选择北京医院内科高血压门诊就诊的成年高血压病患者,进行问卷调查和口腔健康检查.分为服用非硝苯地平钙离子拮抗剂的患者(简称服药组)及从未服用过钙离子拮抗剂的患者(简称对照组).问卷调查内容包括患者的一般状况,高血压患病史,服药史以及口腔卫生习惯等.口腔健康检查包括菌斑指数(plaque index PLI)、简化牙石指数(simple calculus index CI-S)、以及牙龈增生指数(gingival hyperplasia index HI)的检查和记录.结果:对照组患者牙龈增生患病率6.03%,服药组患者牙龈增生患病率31.25%,两者间的差异有显著性(P＜0.001),并且服药组患者中严重牙龈增生的患病率19.23%也显著高于对照组1.59%(P＜0.001).对照组平均HI值为1.4%,服药组平均HI值为10%,两者间的差异有显著性(P＜0.001).结论:服用非硝苯地平钙离子拮抗剂与高血压患者牙龈增生的患病间有显著相关性.     

阻塞性睡眠呼吸暂停综合征矫治后的上气道磁共振影像改变

目的　探讨阻塞性睡眠呼吸暂停综合征 (obstructivesleepapneasyndrome ,OSAS)患者戴用口腔矫治器后 ,其上气道磁共振 (magneticresonanceimaging ,MRI)影像发生的改变。方法　选择 11例有治疗前后多导睡眠图评价、磁共振影像资料完整的OSAS患者 ,用于研究矫治器对上气道的形态学改变 ;另选 11名性别、年龄配比的无睡眠呼吸障碍者 ,作为MRI三维形态研究的对照组。结果　经口腔矫治器治疗后 ,OSAS上气道的内径、截面积、体积均有增大 ,总体积由 ( 12 2 7± 4 13 )ml增加到( 13 93± 4 5 8)ml(P <0 0 1) ;口咽由 ( 5 5 5± 2 10 )ml增加到 ( 6 88± 2 2 6)ml(P <0 0 0 1)。但治疗后的OSAS患者与无睡眠呼吸障碍者比较 ,仍存在鼻咽较小、软腭及舌体较大的差异。结论　口腔矫治器可明显扩张上气道 ,以口咽部为主 ;治疗后的OSAS上气道仍与正常对照存在差异。MRI作为一种影像学手段 ,在OSAS研究中有独到和重要的作用。     

体重指数、颈围及颅面特征与阻塞性睡眠呼吸暂停综合征的关系

目的　研究阻塞性睡眠呼吸暂停综合征 (OSAS)及鼾症患者人体体重指数、颈围、颅面结构特征与呼吸暂停及低通气指数 (AHI)的关系。方法　 15 9名欧洲白种OSAS鼾症患者。OSAS诊断标准为AHI>15次 /小时 ,AHI 15次 /小时者为鼾症。每位患者拍摄自然头位X线头颅侧位片 ,临床检查 (体重指数、颈围 )及多导睡眠仪检查。患者又依体重指数 (BMI)分组 ,BMI >2 5 2 5为正常 ,BMI >2 5为超重。统计分析为t检验 ,相关分析及多因素逐步回归。结果　OSAS及鼾症患者之间的体重指数及颈围大小无显著性差异。男性OSAS患者的软腭长度大于鼾症者。相关分析结果为AHI与患者的颈围、体重指数、下颌位置、下颌平面角相关。多因素回归分析结果表明在超重OSAS患者中AHI与颈围及下颌平面角相关 ,而体重正常的OSAS患者 ,AHI与气道宽度、软腭长度相关。超重OSAS患者按性别分组后 ,男性组AHI与体重指数相关 ,女性组AHI与颈围大小相关。结论　在OSAS与鼾症患者之间存在一些气道结构上差异。男性、女性及超重、正常体重AHI的不同的相关关系表明 ,它们之间存在一些病生理上的差异。     

CXC类趋化因子12及其受体在口腔扁平苔藓中的表达

目的:检测CXCL12及CXCR4在口腔扁平苔藓中(OLP)的表达及分布.方法:将31例01P黏膜标本按病损类型分型、分级,免疫组化检测CXCL12及CXCR4的表达,测量CXCL12及CXCR4的累积光密度值(IOD).结果:①OLP组织中可以检测到CXCL12及CXCR4表达,其表达向表层扩展且逐渐增强.②依临床分型分组,网纹组、糜烂组与对照组差异均具有统计学意义(P＜0.05);网纹型与糜烂型相比,CXCL12的IOD降低,CXCR4的IOD升高,网纹组与糜烂组差异无统计学意义(P＞0.05).③CXCL12及CXCR4依临床分级分组,5组之间的差异没有统计学意义(P＞0.05),且临床分级与IOD无明显相关性(P＞0.05).④CXCL12的IOD与CXCR4的IOD呈正相关.结论:CXCL12及CXCR4在OLP中分布及表达的差异,提示CXCL12/CXCR4轴在OLP的发生发展中可能起到一定作用.     

口腔矫正器治疗阻塞性睡眠呼吸暂停综合征的疗效

目的阻塞性睡眠呼吸暂停综合征(ObstructiveSleepApneaSyndrome,OSAS)是由上气道狭窄或阻塞而导致的夜间睡眠呼吸的反复暂停,是对人类寿命和生活质量造成严重影响的疾病.口腔矫正器(特别是下颌前移器)对OSAS的治疗结果,日益引起多学科研究者的关注.本文旨在对我院1994年以来收治的OSAS患者,其口腔矫正器的客观疗效进行评价.方法患者来自1994年制作下颌前移器.其中70名患者,平均年龄52.75±10.19岁,轻(AHI5-19)、中(AHI20-49)、重(AHI50-)比例为242224,取得戴用口腔矫正器后的多导睡眠监测客观评价.结果(1)戴用矫正器后,AHI平均由37.64±23.09/小时降至8.97±10.36/小时;最低血氧饱和度由72.37±11.44%提高到82.65±8.9%;(2)回复到正常范围内33人,治愈率为47.14%;AHI有改善但改善幅度小于50%者6人,占8.57%;AHI无改善或恶化者3人,失败率为4.29%;(3)治疗失败3人均为中度患者;疗效欠佳者2人重度,4人轻度.结论(1)口腔矫正器的客观有效率87.14%.仅次于经鼻持续正压通气治疗(CPAP),大大高于耳鼻喉手术等疗法,且为保守治疗,前景良好.(2)口腔矫正器对轻、中、重患者的病情均有改善,适合较广泛的OSAS患者群,结合其舒适简便的特点,有较好的推广价值.(3)轻、中、重患者都有治疗欠佳者,揭示OSAS病因机制复杂,对该病病理过程和口腔矫正器机制仍有待深入研究.     

Craniofacial skeletal architecture and obstructive sleep apnoea syndrome severity

Obstructive sleep apnoea syndrome (OSAS) is a sleep related breathing disorder caused by pharynx obstruction that often terminates in abrupt arousals and is capable of disrupting physiological sleep profile. Its' severity has been associated, among others, with craniofacial skeletal morphology. To investigate this relationship and elucidate craniofacial skeleton patterns in individuals without obvious maxillofacial abnormalities, 171 OSAS patients were studied with nocturnal polysomnographic record and chephalometric X-ray (24 variables). Chephalometric variables were compared between three apnoea/hypopnoea index (AHI) groups (AHI ≤ 15; 15 < AHI < 30; AHI ≥ 30) and uni/multivariate analysis between chephalometric variables and AHI were performed.The patients were predominantly men (83%), with a mean age of 48.1 years. Mean BMI and AHI were 28.4 kg/m² and 26.2, respectively. Most chephalometric variables differed among the three AHI groups. Fifteen chephalometric variables showed a correlation with AHI. Five chephalometric variables and BMI were independent AHI predictors. Chephalometric variables were better AHI predictors in normal weight patients.Significant evidence of craniofacial skeleton influence was found on OSAS severity, caudalization of the hyoid and lower sagittal facial projection being the most important patterns. From the chephalometric variables analysed, the hypopharynx calibre demonstrated a higher predictive value for AHI, independently of BMI.     

两种检测方法在寻常型天疱疮诊断中的作用

目的 研究桥粒芯糖蛋白-酶联免疫吸附测定(desmoglein enzyme-linked immunosorbent assay,Dsg-ELISA)法检测寻常型天疱疮(pemphigus vulgaris,PV)抗体在PV诊断中的作用,以期为临床提供参考.方法 用Dsg-ELISA、猴食道为底物的间接免疫荧光法(...     

阻塞性睡眠呼吸暂停低通气综合征患者肥胖与血清胱抑素C水平的关系

目的：观察阻塞性睡眠呼吸暂停低通气综合征( OSAHS)患者肥胖与血清胱抑素水平的关系,探讨肥胖对OSAHS疾病严重性及OSAHS患者泌尿系统疾病风险的影响。方法运用随机抽样的方法选取我院2008年1月至2015年1月收治的90例阻塞性睡眠呼吸暂停低通气综合征患者和30名20~60岁非OSAHS社区健康人群(均排除基础代谢类疾病),按照呼吸暂停及低通气指数( apnea and hypopnea index, AHI)分类分别记为轻、中、重三个亚组和对照组。应用多导睡眠监测仪记录患者睡眠参数,对研究组和对照组患者行入院后静脉抽血检验,监测血清胱抑素C水平和体重指数( BMI)指数。结果 OSAHS患者各组呼吸暂停及低通气指数( AHI)、氧减饱和度指数(oxygen desaturation index,ODI)、BMI及血清胱抑素C均显著大于对照组(P<0．05),且随OSAHS严重程度增加而增高,而最低血氧饱和度(L-SaO2)和平均血氧饱和度(M-SaO2)则呈下降趋势。 OSAHS患者中肥胖组的AHI、ODI、血清胱抑素C较非肥胖组明显增加,L-SaO2和M-SaO2显著降低( P<0．05),且BMI、ODI与血清胱抑素C呈正相关( P <0．05), L-SaO2和 M-SaO2与血清胱抑素 C 呈负相关性( P <0．05)。结论肥胖能够加重OSAHS患者疾病严重程度,并能提高血清胱抑素C的水平。 OSAHS患者的BMI指数与血清胱抑素C水平呈正相关。     

下颌适度前移矫治器治疗对阻塞性睡眠呼吸暂停及上气道容积的影响

目的:研究下颌适度前移矫治器(mandibular advancement device,MAD)治疗对阻塞性睡眠呼吸暂停(ob-structive sleep apnea syndrome,OSAS)及上气道容积的影响.方法:选择2017年6月～2018年9月经河南省中医院收治的阻塞性睡眠呼吸暂停综合征患者57例进行...     

阻塞性睡眠呼吸暂停综合征矫治后的上气道磁共振影响改变

目的探讨阻塞性睡眠呼吸暂停综合征（ｏｂｓｔｒｕｃｔｉｖｅ ｓｌｅｅｐ ａｐｎｅａ ｓｙｎｄｒｏｍｅ，ＯＳＡＳ）患者戴用口腔矫治器后，其上气道磁共振（ｍａｇｎｅｔｉｃ ｒｅｓｏｎａｎｃｅ ｉｍａｇｉｎｇ，ＭＲＩ）影像发生的改变。方法 选择１１例有治疗前后多导睡眠图评价、磁共振影像资料完整的ＯＳＡＳ患者，用于研究矫治器对上气道的形态学改变；另选１１名性别、年龄配比的无睡眠呼吸障碍者，作为ＭＲＩ三维形态     

Comparison of tongue volume/oral cavity volume ratio between obstructive sleep apnea syndrome patients and normal adults using magnetic resonance imaging

Obstructive sleep apnea syndrome (OSAS) is a group of disorders in which breathing stops intermittently and repeatedly for 10 seconds or more during sleep. The causal site of the disorders is thought to be in the upper airway above the glottis. In order to understand the three-dimensional features of the oral and peripharyngeal structures involved in the disorders, we calculated the tongue volume/oral cavity volume ratio (TV/OCV ratio) in the oral cavity using magnetic resonance imaging (MRI) for both OSAS patients and normal controls. The study subjects comprised 20 male patients with OSAS (apnea-hypopnea index [AHI] > or = 5.0, with a diagnosis of OSAS) and 20 normal male adults (AHI<5.0, with no history of OSAS) as the controls. We performed MRI to acquire T1- and T2-weighted images. We estimated tongue volumes on the basis of the cross-sectional area of each image, then using the tongue volume data, we calculated TV/OCV ratios. In the normal control group, mean (+/- SD) body mass index (BMI) was 21.68 +/- 1.73 and the mean TV/OCV ratio was 86.98 +/- 3.16%, whereas these values were 25.0 +/- 15.94 and 90.56 +/- 2.15%, respectively, in the OSAS patient group. The TV/OCV ratio of the OSAS patient group was significantly higher than that of the normal control group (p<0.01).     

Do salivary and serum collagenases have a role in an association between obstructive sleep apnea syndrome and periodontal disease? A preliminary case–control study

Objectives

Despite increasing evidence for an association of obstructive sleep apnea syndrome (OSAS) and periodontal disease, the pathophysiological linking mechanisms remain unclear. This study aims to evaluate the salivary and serum matrix metalloproteinase-2, -8, -9 (MMP-2, -8, -9), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), myeloperoxidase (MPO), neutrophil elastase (NE), neutrophil gelatinase-associated lipocalin (NGAL), as well as degree of activation of MMP-2, -9 of patients with and without OSAS.

Design

A total of 50 individuals were included in the study. There were 13, 17 and 20 individuals, respectively in the control (non-OSAS) group, mild-to-moderate OSAS and severe OSAS groups. Saliva, serum samples and clinical periodontal parameters were collected. Biofluid samples were analysed by immunofluorometric assay (IFMA), enzyme-linked immunosorbent assay (ELISA), western immunoblotting and gelatine zymography. Statistical analyses were performed using D’Agostino–Pearson omnibus normality test, Kruskal–Wallis test and Spearman rho rank correlation analysis.

Results

There were no statistically significant differences in clinical periodontal parameters between the study groups. Salivary NE and proMMP-2 levels were significantly lower in the OSAS groups than the control group (p < 0.05). Serum proMMP-9 concentration and the degree of MMP-9 activation in saliva were significantly lower in the severe OSAS group than the control group (p < 0.05). There were significant correlations between salivary and serum proMMP-9 and -2 concentrations (p < 0.05). Serum proMMP-2, NE and salivary proMMP-9 and -2 negatively correlated with indicators of OSAS severity (p < 0.05).

Conclusions

The present findings do not support a pathophysiological link between the severity of OSAS and clinical periodontal status via neutrophil enzymes or MMPs.     

B细胞活化因子在系统性红斑狼疮伴牙周炎患者中的表达及相关性分析

目的： 检测B细胞活化因子（B-cell activating factor of the TNF family, BAFF）在牙周炎（periodontitis）和系统性红斑狼疮（systemic lupus erythematosus, SLE）患者血清中的含量,探讨BAFF的表达与牙周炎及SLE的关系。方法： 按纳入标准,选取就诊于中国医科大学附属盛京医院口腔科及风湿免疫科的患者,其中牙周炎组19例（P组）,系统性红斑狼疮组22例（SLE组）,系统性红斑狼疮合并牙周炎组24例（SLE+P组）,健康对照20例（H组）。记录4组受试者一般信息, 牙周探诊深度（periodontal probing depth, PD）、临床附着丧失（clinical attachment loss, CAL）、龈沟出血指数（sulcus bleeding index, SBI）。收集各组患者血清样本,应用酶联免疫吸附试验测定BAFF的含量,对SLE组及SLE+P组受试者的风湿免疫学指标进行测定,并对4组受试者BAFF含量与牙周指标进行相关性分析。采用SPSS 20.0 软件包对数据进行统计学分析。结果： P+SLE组的CAL显著高于P组（P<0.05）;SLE+P组、SLE组及P组的血清BAFF浓度显著高于健康组（P<0.05）;SLE+P组血清BAFF浓度显著高于SLE组（P<0.05）;SLE+P组的ESR、SLEDAI及患病时间显著高于SLE组（P<0.05）;血清BAFF表达水平与CAL及SBI呈显著正相关关系（P<0.01）;血清BAFF表达水平与PD呈正相关关系（P<0.05）;血清BAFF水平与患病时间及激素使用时间呈显著正相关关系（P<0.01）;血清BAFF水平与C3呈正相关关系（P<0.05）。结论： SLE与牙周炎具有一定的相关性,SLE伴牙周炎患者血清BAFF显著升高;BAFF可能在SLE和牙周炎的发生、发展中发挥一定作用。     

慢性牙周炎和慢性阻塞性肺疾病急性加重患者血清PCT水平及其与疾病关系探讨

目的 通过比较慢性阻塞性肺疾病急性加重（acute exacerbation of chronic obstructive pulmonary disease,AECOPD）患者和稳定期患者的牙周、肺功能状况及血清降钙素原（serum procalcitonin,PCT）水平,探究AECOPD和牙周炎的内在联系。方法 选择AECOPD、慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）稳定期共90例患者为研究对象,根据患者的牙周炎分期分为8组：AECOPD伴Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期牙周炎和COPD稳定期伴Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期牙周炎。对各组患者的一般信息、牙周袋探诊深度（pocket probing depth,PPD）、临床附着丧失（clinical attachment loss,CAL）、菌斑指数（plaque index,PLI）、龈沟出血指数（sulcus bleeding index,SBI）、第1秒用力呼气容积占用力肺活量百分比（percentage of 1 second expiratory volume to forced vital capacity,FEV1/FVC%）、第1秒用力呼气的容积占预计值的百分比（percentage of the estimated volume of forced exhalation in the first second,FEV1%pred）以及血清降钙素原水平进行统计分析。结果 AECOPD和稳定期患者年龄、性别、BMI、吸烟状况均无统计学意义（P>0.05）;AECOPD患者Ⅲ期、Ⅳ期牙周炎比例明显高于稳定期患者（P＜0.05）;Ⅰ期牙周炎患者中AECOPD组PPD、SBI显著高于稳定期组;Ⅱ期牙周炎患者中AECOPD组PPD、CAL显著高于稳定期组;Ⅲ期牙周炎患者中AECOPD组SBI、CAL显著高于稳定期组;Ⅳ期牙周炎患者中AECOPD组PLI、CAL显著高于稳定期组（P＜0.05）。AECOPD及稳定期患者随着牙周炎严重程度增加,FEV1/FVC%、FEV1%pred依次降低（P＜0.01）。AECOPD组患者血清中不同牙周状况下PCT水平均显著高于稳定期组患者（P＜0.01）;血清中的PCT水平与PPD（r=0.60,P＜0.01）、CAL（r=0.58,P＜0.01）、SBI（r=0.31,P=0.03）成显著正相关,与FEV1/FVC%（r=-0.79,P＜0.01）、FEV1%pred（r=-0.80,P＜0.01）成显著负相关。结论 本研究结果提示牙周炎与AECOPD可能存在相互促进作用,血清PCT可能在一定程度上反映COPD患者牙周炎严重程度及急性加重风险。     

Cephalometric,muscular and swallowing changes in patients with OSAS

Obstructive Sleep Apnoea Syndrome (OSAS) is believed to be associated with craniofacial and neuromuscular changes, although the interplay among these variables still is poorly recognised. The objective of this study was to identify hyoid, muscular and swallowing changes associated with OSAS, and to correlate these alterations with OSAS severity. Cross‐sectional study, in a tertiary referral centre. Seventy‐two adult individuals participated in this study: 12 controls (without apnoea) and 60 patients with apnoea (mild, moderate and severe OSAS—20 individuals in each group). All participants were initially evaluated by otorhinolaryngologist and neurologist and underwent polysomnography for OSAS stratification. Cephalometric data, clinical myofunctional status and swallow videofluoroscopy exam were assessed. A hybrid effect model was used to analyse swallowing parameters; dependent variables were age, body mass index (BMI) and cephalometric measures. Individuals with OSAS presented lower hyoid position and narrower posterior airway distance when compared to controls. These parameters correlated to OSAS severity. Additionally, OSAS patients exhibited significantly lower myofunctional scores. Both velum and hyoid contraction times were significantly lower in the OSAS group at videofluoroscopy, regardless of its severity. Premature leakage into pharynx was more common in OSAS groups. Laryngeal penetration phenomenon occurred only in two patients (both from OSAS group). Our results suggest that hyoid bone position is associated with OSAS severity. Muscular pattern and swallowing are impaired in OSAS patients, irrespective of OSAS severity and facial profile. These findings indicate a higher predisposition of OSAS patients to present an inferior hyoid positioning, accompanied by myofunctional and swallowing disorders.