下颌前移矫正器对阻塞性睡眠呼吸暂停综合征患者上气道影响的X线研究

The Cephalometric Measurement of the Influence of the Mandibular Advancement Splints on Upper Airway Dimension in Sleep Apnoea Patients

目的 研究下颌前移矫正器对阻塞性睡眠呼吸暂停综合征 (OSAS)患者上气道的影响及与颅面形态的关系。方法 148名存在OSAS的北欧白人患者拍摄治疗前及戴用矫正器后的自然头位时X线头颅侧位片。计算机头影测量进行 2 1项项目的测量。比较戴入矫正器前后头影测量的变化。统计分析为配对t检验和多因素逐步回归 ,由SPSS软件包完成。结果 戴入矫正器后患者上气道矢状径在各水平均增加 ,腭咽水平 (SAS)增加 1.76± 2 .0 3mm ;舌咽水平 (PAS)增加了 1.77± 2 .0 3mm ,喉咽水平 (LAS)增加了 1.0 8±0 .97mm。在女性组 ,SAS的增加与戴矫正器后前牙打开的高度负相关 (R2 =0 .174) ;PAS的增加与髁突前移的距离相关 (R2 =0 .31) ;总样本中LAS的变化与软腭长度负相关与覆盖的减小相关 (R2 =0 .6 7) ;女性中LAS与下颌前移量相关 (R2 =0 .194)。结论 下颌前移矫正器能增加患者上气道的宽度 ,变化最显著者在气道口咽部。气道宽度的变化与患者颅面特征相关。

Objective To investigate the influence on upper airway of mandibular advancement splint in a group of obstructive sleep apnoea patients.Method 148 Northern European white obstructive sleep apnoea patients were included into this study. Lateral cephalograms of before and after the oral splint was inserted were taken for each patient, and cephalometrics utilising 21 variables were carried out. Paired t test and multiple stepwise regression were performed.Results Improvement of superior airway(SAS) was 1.76 ± 2.03 mm,posterior airway space(PAS) was 1.77 ± 2.03 mm and inferior airway(LAS) was 1.08 ± 0.97 mm.In the female group, the improvement of SAS was inversely correlated with the anterior bite opening(R 2= 0.174 ); the improvement of PAS was highly correlated to the forward movement of condyle(R 2= 0.31 ).In the overall population, the improvement of LAS correlated with the soft palate length and the reduction of overjet(R 2= 0.67 ) and there were correlation between the improvement of LAS and the mandibular movement in the female group(R 2= 0.194 ).Conclusion The mandibular advancement splint improved the upper airway dimensions in the study sample, and there was significant correlation with a number of cephalometric varables.