阻塞性睡眠呼吸暂停低通气综合征患者颈围与睡眠呼吸参数及上气道径线的相关性研究

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的颈围、睡眠呼吸参数和CT检查上气道径线的相关性。方法 应用多层螺旋CT对61例经多道睡眠监测确诊的OSAHS患者的咽部区域进行连续扫描，分别测量腭咽区和舌咽区最狭窄气道的截面积、各径线长度及气道面积与颈面积比值，统计分析颈围与体质量指数(BMI)、身高、体质量、睡眠呼吸参数、颈部CT测量值之间的相关性。结果 OSAHS患者的颈围与BMI呈正相关(r=0.623，P<0.01)；颈围与氧饱和度低于90的时间占睡眠时间的百分比(T90)呈正相关(r=0.284，P<0.05)、 与氧减指数(ODI)呈正相关(r=0.260，P<0.05)、与最低氧饱和度(LSO2)呈负相关(r=-0.317，P<0.05)；颈围与腭咽、舌咽气道面积与颈面积比值均呈负相关(r=-0.258，P<0.05；r=-0.276，P<0.05)，与腭咽气道软组织前径、舌咽气道软组织后径均呈正相关(r=0.293，P<0.05；r=0.290，P<0.05)。结论 颈围增加可比例缩小OSAHS患者的上呼吸道横截面积，加重上呼吸道塌陷或狭窄、软腭悬雍垂的松弛肥厚及夜间低氧血症的严重程度。颈围对OSAHS的发病有一定预测意义。

Correlation of neck circumference with sleeping-respiratory parameters and dimensions of upper airway in obstructive sleep apnea hypopnea syndrome patients

Objective To analyze the correlation of neck circumference (NC) with sleeping respiratory parameters and dimensions of upper airway in the patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods 61 OSAHS patients diagnosed by polysomnogaphy (PSG) were included in this study. With CT scanning, the velopharyngeal and glossopharyngeal cross sectional area, dimensions of upper airway and the area ratio of pharynx/neck were measured. NC, body mass index (BMI), height and weight were collected. The correlation between NC and the other parameters were analyzed. Results In 61 OSAHS patients, NC was positively correlated with BMI (r=0.623, P<0.01), and positively correlated with T90 and ODI， respectively (r=0.284, P<0.05; r=0.260, P<0.05). NC was negatively correlated with LSaO2 (r=-0.317, P<0.05), as well as two area ratios of pharynx/neck (r=-0.258, P<0.05; r=-0.276, P<0.05). Finally, NC was positively correlated with the front diameter of velopharyngeal region and the back diameter of glossopharygeal region (r=0.293, P<0.05; r=0.290, P<0.05). Conclusion The increasing NC can scale down the cross sectional area of upper airway and aggravate airway obstruction, hypertrophy of soft palate, and hyoxemia. NC is a good predictor for the development of OSAHS.