阻塞性睡眠呼吸暂停低通气综合征患者上气道极速CT测量

The speed CT measurement of the airway in obstructive sleep apnea-hypopnea syndrome

目的:通过极速CT测量阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者上气道,利用上气道各分区的测量值及顺应性来评估OSAHS患者气道阻塞平面,以期为临床诊治提供帮助。方法:随机选取82例OSAHS患者(OSAHS组),无打鼾的健康人45例作为正常对照组,应用PHILIPS 256层螺旋CT(极速CT)对其进行平静呼吸状态(吸气末)测量,及Müller动作下鼻咽区、腭后区、舌后区、会厌后区各区最窄平面各径线及各区气道容积的测量。结果:①OSAHS组行平静呼吸与Müller动作时CT扫描,2种状态下鼻咽区左右径、会厌后区前后径及横截面积差异无统计学意义,其余各组参数间有差异,其中腭后区体积、舌后区前后径、舌后区体积有显著性差异。②Müller动作时,2组会厌后区体积比较差异无统计学意义,鼻咽区左右径、鼻咽区体积、腭后区横截面积、舌后区前后径有差异,其余各组参数间有显著性差异。③2组的气道顺应性(Müller相)比较,各组参数间均有差异,其中鼻咽区前后径、腭后区体积有显著性差异。同时,同一平面内,OSAHS组与正常对照组的左右径均大于前后径。④对阻塞平面的预测,咽腔容积测量与纤维内镜检查结果基本相符。结论:用极速CT测量OSAHS患者上气道,阻塞平面多位于腭后区及舌后区。上气道容积的CT测量可用于OSAHS患者上气道阻塞平面的评估。

Objective： To measure the upper airway of obstructive sleep apnea-hypopnea syndrome by speed CT. We can predict the airway obstruction plane with the airway plane data and compliance in OSAHS patients. Through this measurement, we can provide assistance for clinical diagnosis and treatment. Method：This study ran- domly selected 82 patients diagnosed with OSAHS and 45 cases non-snoring healthy people as control group by the PHILIPS 256-slice CT. The zone volume, sagittal diameter,coronary diameter and cross-sectional area of the nar- rowest plane in nasopharyngeal area, velopharyngeal area, glossopharyngeal area, hypopharynx area in two groups of quiet respiration and Mtiller＇s status were measured. Result： In the OSAHS group underwent quiet breathing and Mtiller movement during CT scanning, the two states about nasopharyngeal coronary diameter, the hypopharynx sagittal diameter and cross-sectional area showed no significant difference, while other groups showed differences between the parameters （P^0.05）. There was significant difference （P%0.01） in the velopharyngeal volume, tongue sagittal diameter and volume. Under Mtiller movement in the OSAHS group and the control group, the hy- popharynx volume showed no significant difference. The nasopharyngeal coronary diameter and volume, velopha- ryngeal cross-sectional area and tongue sagittal diameter were different （P%0.05）. The remaining set of parame- ters showed significant differences （P%0.01）. Compared the airway compliance （Maller phase） of the OSAHS group and the control group,the parameters of each group were different （P%0.05）, of which the nasopharyngeal sagittal diameter, velopharyngeal volume showed significant difference （P〈0.01）. Meanwhile,in the same plane,coronary diameter was greater than sagittal diameter（P（0.05） in both the OSAHS group and the control group. The pharyngeal volume measurement was basically consistent to the fiber endoscopy. Conclusion： The obstruction plate of OSAHS patients is mostly in the velopharyngeal area and glossopharyngeal area measured with a high speed CT. The volume measurement of upper airway with speed CT can predict airway obstruction plate in pa- tients with OSAHS.