无阻塞性睡眠呼吸暂停低通气综合征的31名老年男性上气道及周围组织形态观察

目的研究无阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome,OSAHS）的70岁以上男性上气道及周围组织的结构特征,为深入认识OSAHS的病因及治疗手段提供依据。方法从182名70岁以上男性中,通过问卷和整夜多道睡眠监测（polysomnography,PSG）检测筛选出无OSAHS者31名,睡眠呼吸暂停低通气指数（apnea and hypopnea index,AHI）〈10次／h,年龄70～84岁,平均（74．5±3．7）岁。对31名研究对象行头颈部MRI扫描。对上气道及周围组织的93项指标进行测量。结果①上气道各段平均横截面积、最小横截面积均以腭咽最小,分别为（190．9±67．1）mm^2,（112．1±47．7）mm^2;②上气道各段横截面的前后径与左右径之比在0．22～0．89之间,各段横截面形状均为左右径长、前后径短的椭圆。其中腭咽段比值最小（0．22～0．71）;③上气道各段最小横截面积与最大横截面积之比在0．38～0．62之间,气道立体形状均为“漏斗形”,其中腭咽的“锥度”最大。结论根据上气道横截面大小和形状,无OSAHS老年男性上气道的腭咽段易塌陷。

Morphology of upper airway and surrounding tissues in non-apnea males aged seventy years or over: a magnetic resonance imaging study

OBJECTIVE: To describe the morphology of upper airway in non-apnea males aged seventy years or over. METHODS: Thirty-one non-apnea males aged 70 years or over [diagnosed by whole-night polysomnography (PSG), apnea and hypopnea index (AHI) < 10 per hour] had been taken magnetic resonance imaging (MRI) scanning. RESULTS: The narrowest point of upper airway was at velopharynx. The mean and the minimum section areas were (190.9 +/- 67.1) mm(2) and (112.1 +/- 47.7) mm(2), respectively. Each sagittal/transverse ratio was between 0.22 and 0.89. It showed an ellipse-like cross-section of upper airway, while velopharynx was the most "slender" segment (sagittal/transverse-caliber was 0.22 - 0.71). The min/max section area of upper airway was between 0.38 and 0.62. It demonstrated that each airway segment was a "cone-like" form, while the velopharynx was the steepest segment. CONCLUSIONS: In the non-apnea elderly males aged seventy years or over, the velopharynx was most likely to collapse.