16层螺旋CT对阻塞性睡眠呼吸暂停综合征上气道成像的研究

Upper airway imaging in obstructive sleep apnea syndrome by sixteen -slice spiral CT

目的:应用多层螺旋CT(MSCT)对确诊阻塞性睡眠呼吸暂停综合征(OSAS)患者进行上气道成像,分析其形态特点,为临床综合诊断OSAS及选择治疗提供依据。方法:OSAS患者28例,正常对照组14例,于深吸气末、深呼气末、平静呼吸、闭口堵鼻深吸气(Muller)动作时行上气道MSCT扫描,测量各咽部水平的截面积及相应的矢、横径,软腭的长度及厚度,判断上气道的阻塞情况,计算气道塌陷度。结果:(1)OSAS组腭后区及舌后区截面积比对照组明显狭窄,且多发生在吸气时相(P均<0.01);(2)OSAS组腭后区、舌后区及喉咽部的气道塌陷度较对照组高(P<0.01);(3)OSAS组软腭厚度较对照组厚(P<0.01)。结论:腭后区及舌后区气道明显狭窄伴气道塌陷度的增加可能是OSAS发病的主要原因。

Objectives： To summarize the upper airway imaging characteristics in obstructive sleep apnea syndrome （OSAN） by multislice spiral CT （MSCT）. Methods： The pharynxes of 28 OSAS patients and 14 controls were scanned by MSCT at the time of deep inspiration. deep expiration, normal respiration, and Muller＇s action. Upper airway obstruction and collapse was judged by measuring cross-section area. and sagittal and transverse diameter of pharynx, and the length and thickness of soft palate. Results： （1） Mean cross-section areas of velo-pharynx and tongue-pharynx in OSAS were significantly less than those in control group （P〈0. 01）, which often occurred at the end of inspiration. （2） The collapsibility at velo pharygeal, tongue-pharyngeal and laryngohypopharygeal levels in OSAS was superior to that in control group （P〈0.01）. （3） The soft palate in OSAS was thicker in comparison of controls （P〈0.01）. Conclusion： The straithess and collapse at the velo-pharynx and tongue-pharynx is involved in the pathogenesis of OSAS.