阻塞性睡眠呼吸暂停综合征患者咽腔狭窄多层螺旋CT综合测量值的研究

The measurements of multiple slices CT on the narrow pharyngeal cavity in obstructive sleep apneahypopnea syndrome

目的探讨阻塞性睡眠呼吸暂停综合征(OSAS)患者和正常人在清醒状态下咽部多层螺旋 CT(MSCT)综合测量值及其在临床中的应用价值。方法选择由多导睡眠图确诊为 OSAS 的患者68例,健康对照组56例,分别进行清醒状态下平和呼吸 MSCT 扫描,比较各测量值及比值,并将上述指标代入判别分析方程。结果在63个自变量指标中,49个指标2组差异有统计学意义(P<0.05)。将所有指标分别代入判别分析方程,其中软腭后区(RP)左右径(LR)[OSAS组为(9.4±3.7)mm,对照组为(20.1±5.0)mm;t=-13.820,P=0.000]及最小横截面积(XSA)[OSAS 组为(54±27)mm^2,对照组为(164±77)mm^2;t=-10.944,P=0.000]、舌高[OSAS 组为(75.4±8.3)mm,对照组为(58.4±9.8)mm;t=10.476,P=0.000)、悬雍垂长/气道长(OSAS 组为0.139±0.039,对照组为0.154±0.048,t=-1.983,P=0.050)4项指标被选入判别分析方程式。OSAS 组阳性66例(97.1%),对照组阴性52例(92.9%)。结论多项测量值及比值的比较显示2组间差异有统计学意义,但数值有重叠。判别分析方程式的引入有助于 MSCT 对 OSAS 的诊断。

Objective To define the characteristic values of the pharyngeal cavity by comparing the values of measures and ratios between the patients with obstructive sleep apnea-hypopnea syndrome （OSAS） and controls. Methods Sixty-eight OSAS patients who were diagnosed using polysomnography, and 56 healthy people were scanned by MSCT （multiple slices computed tomography） in the awake state. Then, the values were measured on the reformated images and were compared between two groups. Results Of the 63 values, 49 values were different between the two groups, and among those, 4 values were entered into the Discriminant Functions. These were the left-right diameter （ LR ） [ OSAS ： LR = （ 9.4 ± 3.7 ） mm, controls ： LR = （20. 1± 5. 0） mm, t = - 13.820, P = 0. 000） and the cross-sectional area （XSA） [ OSAS： XSA = （54 ±27）mm^2 ,controls： XSA = （ 164 ± 77 ） mm^2, t = - 10. 944, P = 0. 000] of RP, the heights of tongue [ OSAS ： （ 75.4 ± 8.3 ） mm, controls ： （ 58. 4 ± 9. 8 ） mm, t = 10. 476, P = 0. 000 ] , the lengths of uvula/the lengths of airway（ OSAS：0. 139 ± 0. 039, controls ： 0. 154 ± 0. 048, t - - 1. 983, P = 0. 050 ）. Conclusions Many measures and ratios were different between the two groups, but there were overlaps between them. Measures using the Discriminant Functions can help the diagnosis of OSAS.