阻塞性睡眠呼吸暂停低通气综合征患者颞下颌关节间隙测量

目的:通过对阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者的颞下颌关节(temporomandibular joint,TMJ)行磁共振扫描分析,探讨OSAHS患者与正常人群颞下颌关节形态的差异.方法:选取2014年1月-2016年5月收治的18例OSAHS患者和18例健康成人,分别记为研究组和对照组;按照呼吸暂停及低通气指数(apnea and hypopnea index,AHI),将OSAHS患者分为轻、中、重3个亚组(n=6).对所有纳入人群行TMJ的MRI扫描并测量关节间隙,采用SPSS 17.0软件包对测量数据进行统计学处理.结果:2组患者在年龄、性别构成、关节上间隙及髁突有无移位方面差异均无显著性(P＞0.05).OSAHS患者TMJ左侧前间隙(2.61±0.19)mm:(2.47±0.18)mm,P＜0.05]、右侧前间隙(2.63±0.18)mm:(2.48±0.17)mm,P＜0.0S]大于正常人群.OSAHS患者TMJ左侧后间隙(2.43±0.20)mm:(2.51±0.19)mm,P＜0.05]、右侧后间隙(2.44±0.20)mm:(2.60±0.13)mm,P＜0.05]小于正常人群.轻度OSAHS组TMJ左侧前间隙(2.53±0.26)mm:(2.73±0.07) mm,P＜0.05]、右侧前间隙(2.54±0.11)mm:(2.74±0.14)mm,P＜0.05]均小于重度组;轻度OSAHS组TMJ左侧后间隙(2.56±0.29)mm:(2.29±0.09)mm,P＜0.05]、右侧后间隙(2.55±0.23) mm:(2.31±0.09)mm,P＜0.05]均大于重度组.结论:OSAHS患者的髁突相比正常人群处于关节窝偏后位置.髁突位于关节窝偏后位置的趋势与OSAHS的严重程度相关.

Measurement of temporomandibular joint space of patients with obstructive sleep apnea hypopnea syndrome

PURPOSE:This research evaluated the morphological differences of temporomandibular joint (TMJ) between patients with obstructive sleep apnea hypopnea Syndrome (OSAHS) and normal population using magnetic resonance imaging (MRI).METHODS:Eighteen OSAHS patients were admitted from January 2014 to May 2016 and 18 healthy adults were chosen as control.OSAHS patients were divided into three sub-groups (n=6),i.e.the mild group,the moderate group and the severe group,according to apnea and hypopnea index (AHI).All subjects underwent TMJ MRI for measurement of joint space.Statistical analysis was performed using SPSS 17.0 software package.RESULTS:There was no significant difference between the two groups in age,gender,superior joint space and displacement of condyle.The left anterior joint space (2.63±0.18)mm vs (2.48±0.17)mm,P＜O.05] and right anterior joint space (2.63±0.18) mm vs (2.48± 0.17) mm,P＜0.05] of the TMJ of OSAHS patients was bigger than that of healthy people.The left posterior joint space (2.43±0.20) mm vs (2.51±0.19) mm,P＜0.05] and right posterior joint space (2.44±0.20) mm vs (2.60±0.13) ram,P＜0.05]of the TMJ of OSAHS patients was smaller than that of healthy people.The left anterior joint space (2.53±0.26) mm vs (2.73±0.07) mm,P＜0.05] and right anterior joint space (2.54±0.11) mm vs (2.74±0.14) mm,P＜0.05] of the TMJ of OSAHS patients in the mild sub-group was smaller than that of the OSAHS patients in the severe sub-group;the left posterior joint space (2.56±0.29) mm vs (2.29±0.09) mm,P＜0.05] and right posterior joint space of OSAHS patients in the mild sub-group was bigger than that of the OSAHS patients in the severe sub-group.CONCLUSIONS:The condyle of OSAHS patients is at the posterior position of glenoid compared with heath people.The tendency of posterior position of condyle at glenoid is related to the severity of OSAHS.