螺旋CT和便携睡眠监测阻塞定位仪评估OSAHS上气道狭窄

目的:研究螺旋CT和便携睡眠监测阻塞定位仪(apnea graphy,AG)在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)诊断中的临床应用价值。方法:22例睡眠打鼾患者,便携睡眠监测阻塞定位仪进行整夜睡眠呼吸监测,分析呼吸紊乱指标、出现呼吸暂停低通气事件时的阻塞平面,不同平面的阻塞次数和总阻塞次数。上气道多层螺旋CT自鼻咽部顶壁平扫至环状软骨下缘平面,测量清醒状态下上气道的软腭后区、舌后区气道的横截面积及冠、矢状径。将AG测定上气道狭窄平面与CT测量判断平面进行比较。结果:①22例患者均很好耐受整夜AG监测,16例符合OSAHS,其中轻度2例,中度8例,重度6例。6例排除OSAHS;②16例OSAHS中AG测压均为上部和下部联合阻塞,上部阻塞为主13例,其中1例上部阻塞为100%,下部阻塞为主3例。不同病例上部、下部阻塞频度不同,多为上部阻塞为主;③22例CT测量中4例无狭窄平面,14例腭后区狭窄,1例舌后区狭窄,3例腭后区、舌后区双重狭窄;④16例OSAHS中,AG测压腭后区阻塞为主13/16,CT测量腭后区狭窄12/16,无统计学差异(P>0.05)。AG测压下部阻塞为主3/16,CT测量舌后区阻塞4/16。结论:AG作为便携PSG对OSAHS定性定位诊断具有重要作用,结合CT测量可以很好地评估上气道腭后区狭窄。

Evaluation of upper airway obstruction site in OSAHS by CT and ApneaGraph

Objective:To evalnate the clinical value of CT measurement and ApneaGragh in the diagnosis of obstructive sleep apnea hypopnea syndrome.Methods:Twenty-two snoring patients underwent one-night pressure monitoring by ApneaGragh.The measured data included apnea hypopnea index(AHl),the site of upper airway collapse,and the obstructive proportion of different level.The upper airway levels from the roof of nasopharynx to the inferior border of annular cartilage were sacanned by spiral CT.The coronary and arrowy d...