OSAHS不同呼吸时相上气道变化的多层螺旋CT评价

目的：评价阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者不同呼吸时相时,上气道相关径线的变化并分析其与睡眠呼吸暂停低通气指数（AHI）的相关性,以了解OSAHS患者上气道动态变化的特点。材料和方法：应用16层螺旋CT分别对45例OSAHS患者及11例健康对照者进行吸气和呼气状态下的上气道扫描,测量腭后区、舌后区最小面积层的轴面积、前后径、左右径、后壁;测量软腭悬雍垂长径、软腭厚度及冠状位曲面重组图像的最厚左、右侧壁,并与多导睡眠监测（PSG）结果进行相关分析。结果：①无论吸气还是呼气,OSAHS患者腭后区和舌后区最小面积层,除前后径外,左右径、面积、后壁以及软腭长度、厚度、咽腔侧壁厚度与正常人都存在统计学差异。患者组和对照组上气道所测量各径线的均值变化趋势一致。患者组腭后区的左右径,呼气时相较吸气时相的减小有统计学意义,P〈0.05。对照组的变化没有统计学意义。患者组软腭长度在呼气时较吸气时缩短有统计学意义,P〈0.001;②呼气时相的腭后区最小面积层轴面积、前后径、左右径与AHI呈负相关。结论：在不同的呼吸时相中,OSAHS患者及正常人上气道均存在相同的动态变化,而OSAHS患者在呼气相中,咽侧壁顺应性更明显。CT评估上气道时,在呼气时相更为合适。舌后区的动态变化不同于腭后区,二者应分别评价。

Evaluation of daanges of the upper airway dimensions in different phases of respiration in patients with OSAHS by MSCT

Objective： To evaluate the changes in upper airway dimensions in different phases of respiration in patients with obstructive sleep apnea-hypopnea syndrome（OSAHS） and the control group. The correlation between these dimensions and the apnea-hypopnea index（AHI） results were also analysed to know the characteristics about the dynamic changes of upper airway in OSAHS patients. Materials and Methods： Forty-five OSAHS patients and 11 normal persons were evaluated by 16- slice spiral CT. To measure the area, anteroposterior and lateral dimensions, retropharyngeal tissue of the smallest cross-sectional areas of both retropalatal and retroglossal space of the upper airway during inspiration and expiration. The length and the thickness of soft palate, as well as the thickest right and left side walls were measured. The correlation between these dimensions and the PSG results were analyzed. Results： （1）There was statistically significant difference among area, lateral dimensions, retropharyngeal tissue of the smallest cross-sectional areas of both retropalatal and retroglossal space of the upper airway during inspiration and expiration between the two groups. So did the length, the thickness of the soft palate and the side walls. There was no significant difference according to anteroposterior dimensions. The trend of the changes of these dimensions is the same between the groups. The OSAHS patients had significantly smaller lateral dimensions of the retropalatal space and the length of the soft palate in expiration compared with inspiration （P〈0.05）. There was no significant difference in the control group. ②here were negative correlations between the area, the anteroposterior, lateral diameters and AHI in expiration. Conclusions In different phase of respiration, there were similar dynamic changes in the upper airway between OSAHS patients and normal persons. The side walls of the upper airway of OSAHS patients were more collapsed than that of the normal persons. It will be more suitable for CT