阻塞性睡眠呼吸暂停低通气综合征患者计算机辅助下颌定位系统的研制与矫治器疗效预测

目的研制适用于阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的计算机辅助下颌前伸定位系统（CAMRS），利用该系统初步判定OSAHS患者的下颌最适前伸距离，预测其口腔矫治器的疗效。方法CAMRS通过计算机控制微型步进电机，借助螺母与螺栓问的相对移动控制下颌前伸，结合多导睡眠图（PSG）监测，对14例OSAHS患者夜间睡眠进行下颌前伸定位和口腔矫治器疗效预测。结果CAMRS运行稳定，能有效前伸下颌，对睡眠干扰小。14例患者随着下颌的逐步前伸，睡眠呼吸暂停低通气指数（AHI）逐步改善，但每例患者的下颌最适前伸距离不同，与其病情的严重程度呈正相关关系（r=0．72747）。结论新研制的CAMRS系统运行稳定有效，对睡眠干扰小。通过该系统可以预先确定OSAHS患者的下颌最适前伸距离，并预测口腔矫治器的疗效。

Computer-aided mandibular repositioning system for efficacy prediction of oral appliance in patients with obstructive sleep apnea-hypopnea syndrome

Objective To develop a computer-aided mandibular repositioning system (CAMRS) and investigate its preliminary application in efficacy prediction of oral appliance in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods CAMRS was mainly consisting of a step motor and a screw that was remote-controlled by a computer. This system could work with polysomnography(PSG). Fourteen OSAHS patients diagnosed by PSG were recruited. With CAMRS, six mandibular positions were titrated with PSG for every hour. Results Stable mandible positioning and little sleeping disturbance were observed. Apnea hypopnea index(AHI) was improved progressively with mandibular advancement. The extent of mandibular advancement was correlated with the severity of OSAHS(r=0.727 47). Conclusions CAMRS could reproductively and effectively reposition mandible with little sleeping disturbance. Through CAMRS, an individualized optimal mandibular position could be obtained for each OSAHS patient treated with oral appliance.