阻塞性睡眠呼吸暂停低通气综合征患者鼻腔空气动力学特征

目的通过比较阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者和正常人鼻腔空气动力学指标差异，了解OSAHS患者鼻腔流场特征，为研究OSAHS发病机制提供依据。方法成人志愿者和OSAHS患者各60例，进行上气道高分辨CT扫描，进行三维图像重建，网格划分，借助Fluent软件进行数值模拟计算，运用后处理软件对鼻腔空气动力学特征进行计算流体力学分析。比较患者和正常人鼻腔流场变化，鼻腔黏膜面积、鼻腔容积、黏膜面积-容积比和鼻阻力等指标差异。结果OSAHS患者压力、速度梯度比正常人变化显著，正常人鼻腔黏膜面积显著低于OSAHS患者[（161．2±34．7）cm^2 vs （176．8±22．9）cm^2，P〈0．01]：鼻腔容积显著高于OSAHS患者[（31．7±8．1）ml vs （25．6±7．3）ml，P〈0．011；鼻腔黏膜面积一容积比显著低于OSAHS患者（0.57±0．09 vs 0．65±0．11，P〈0．01）；鼻腔气道总阻力显著低于OSAHS患者[（0.211±0．085）kPa·S·L^-1 vs （0．828±1．268）kPa·S·L^-1，P〈0．01]。结论OSAHS患者与正常人鼻腔空气动力学指标有显著差异，其鼻腔流场改变，可能与OSAHS发病有一定关系。

Nasal aerodynamics characteristics in obstructive sleep apnea hypopnea syndrome patients

OBJECTIVE To compare the aerodynamic differences of nasal airflow between normal subjects and patients with OSAHS. METHODS There are 60 normal subjects [ （31.4±7.1） years] and 60 OSAHS patients [ （36.7±13.2） years] in this study. Pre-operative upper airway CT of each subject was acquired. By means of CFD simulation method, numerical simulation was performed to calculate the airflow dynamic indexes of the nasal cavity. RESULTS Mucosal areas of nasal cavity in normal subjects were significantly lower than in OSAHS patients （161.2±34.7 vs 176.8±22.9, P〈0.01） . Volumes of nasal cavity in normal subjects were significantly larger than in OSAHS patients （31.7±8.1 vs 25.6±7.3, P〈0.01） . The surface area and volume ratios of nasal cavity in normal subjects were significantly lower than that in OSAHS patients （0.57±0.09 vs 0.65±0.11, P〈0.01） . The total nasal airway resistance in normal subjects were significantly lower than in OSAHS patients （0.211±0.085 vs 0.828±1.268, P〈0.01） . CONCLUSION Airflow dynamic indexes of OSAHS patients had significant different nasal aerodynamic characteristics from normal subjects. Abnormal structure of nasal cavity induced discrepant nasal airflow dynamic characteristics. These aerodynamic changes could be associated with the incidence of OSAHS.