阻塞性睡眠呼吸暂停低通气综合征患者睡眠时咽部CT与体质量的关系研究

Relationship between body mass index and CT measure of pharynx about patients with obstructive sleep apnea hyponea syndrome in sleeping

目的探讨睡眠状态下阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）患者咽部CT测量与体质量的关系。方法在于天津医科大学总医院行多导睡眠监测被确诊为OSAHS的患者中随机选取40例可以配合的患者进行睡眠状态下螺旋CT扫描，依体质量指数（body mass index，BMI）将其分为BMIG25组和BMI≥25组，比较两组一般资料[平均年龄、颈围、最低血氧饱和度、睡眠呼吸暂停低通气指数（apnea hypopnea index，AHI）、吸烟情况、醒时血氧饱和度]及咽腔形态学（包括鼻咽和口咽的最小面积，舌体长度、厚度和面积，软腭长度、厚度和横截面积，悬雍垂直径等）的差异。结果睡眠状态下，BMI≥25的患者颈围、AHI明显高于BMIG25的患者（P〈0．01），而最低血氧饱和度明显低于后者（P〈0．001），同时BMI≥25患者的舌体长度、舌体面积较BMIG25患者明显增加（P〈0．001），软腭后区最小横截面积减小（P〈0．05），而舌后区最小横截面积、舌体厚度、软腭长度、软腭厚度、软腭横截面积及悬雍垂直径随着BMI的增大有增加趋势，但两组间差别无统计学意义。相关分析结果也显示AHI与BMI呈正相关（r=0．608，P〈0．001）。结论睡眠状态下不同BMI的OSAHS患者之间气道结构存在一定的差异，同时BMI与AHI有相关性，提示BMI可反映OSAHS患者上气道阻塞程度。

Objective To investigate relatioship between body mass index （BMI） and CT measurement of pharynx about obstructive sleep apnea hypopnea syndrome（OSAHS） patients in sleeping. Methods Among the patients diagnosed as OSAHS with PSG testing in the hospital, 40 eases, who were compatible with the sleep state of spiral CT scanning, were randomly selected, and they were divided into two groups by body mass index（BMI） ： BMI〈 25 group and BMI≥ 25 group. Comparison between two groups were made concerning general condition [average age,neck circumference,minimal oxygen saturation, （apnea hypopnea index, AHI）, smoking, wake oxygen saturation] and shapes of pharyngnx （minimum areas of nasopharynx and oropharynx, length, thickness and area of tongue, length, thickness and cross-sectional area of soft palate,uvula diameter, ere）. Results In sleeping, data comparative results of different BMI were as follows：neck circumference, AHI in BMI≥25 group were higher than those in BMI〈25 group（ P 〈0.01）, minimal oxygen saturation in BMI≥25 group was lower than that in BMI〈25 group（ P 〈0. 001）. At the same time, the former had larger length and area of tongue（ P 〈0.001）,and smaller minimum area of retropalatal region（ P 〈0.05）. With increase of BMI, the minimun area of retroglossal region, length, thickness and area of soft palate tongue thickness increased. But there were no statistical significance. At the same time,correlation analysis showed significant positive correlation between AHI and BMI （ r = 0. 608, P 〈 0. 001）. Conclusions There is obviously difference between different BMI of OSAHS patients in sleeping, and AHI is associated with BMI. BMI can reflect the degree of upper airway obstruction in OSAHS patients,