无阻塞性睡眠呼吸暂停低通气综合征的31名老年男性上气道及周围组织形态观察

Morphology of upper airway and surrounding tissues in non-apnea males aged seventy years or over:a magnetic resonance imaging study

目的研究无阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopneasyndrome,OSAHS)的70岁以上男性上气道及周围组织的结构特征,为深入认识 OSAHS 的病因及治疗手段提供依据。方法从182名70岁以上男性中,通过问卷和整夜多道睡眠监测(polysomnography,PSG)检测筛选出无 OSAHS 者31名,睡眠呼吸暂停低通气指数(apnea andhypopnea index,AHI)<10次/h,年龄70～84岁,平均(74.5±3.7)岁。对31名研究对象行头颈部MRI 扫描。对上气道及周围组织的93项指标进行测量。结果①上气道各段平均横截血积、最小横截面积均以腭咽最小,分别为(190.9±67.1)mm^2,(112.1±47.7)mm^2;②上气道各段横截面的前后径与左右径之比在0.22～0.89之间,各段横截面形状均为左右径长、前后径短的椭圆,其中腭咽段比值最小(0.22～0.71);③上气道各段最小横截面积与最大横截面积之比在0.38～0.62之间,气道立体形状均为"漏斗形",其中腭咽的"锥度"最大。结论根据上气道横截面大小和形状,无 OSAHS 老年男性上气道的腭咽段易塌陷。

Objective To describe the morphology of upper airway in non-apnea males aged seventy years or over. Methods Thirty-one non-apnea males aged 70 years or over [ diagnosed by whole-night polysomnography （ PSG ）, apnea and hypopnea index （ AHI ） 〈 10 per hour ] had been taken magnetic resonance imaging （MRI） scanning. Results The narrowest point of upper airway was at velopharynx. The mean and the minimum section areas were （ 190. 9 ± 67.1 ）mm^2 and （ 112. 1 ± 47.7 ） mm^2, respectively. Each sagittal / transverse ratio was between 0. 22 and 0. 89. It showed an ellipse-llke cross-section of upper airway, while velopharynx was the most ＂slender＂ segment （sagittal / transverse-caliber was 0. 22-0. 71 ）. The rain/max section area of upper airway was between 0. 38 and 0. 62. It demonstrated that each airway segment was a ＂cone-like＂ form, while the velopharynx was the steepest segment. Conclusions In the nonapnea elderly males aged seventy years or over, the velopharynx was most likely to collapse.