体重指数、颈围及颅面特征与阻塞性睡眠呼吸暂停综合征的关系

The Relationship Between the Body Mass Index,Neck Size,Cephalometrics and Severity of Sleep Apnoea in A sample of Snoring and Sleep Apnoea Patients.

目的 研究阻塞性睡眠呼吸暂停综合征 (OSAS)及鼾症患者人体体重指数、颈围、颅面结构特征与呼吸暂停及低通气指数 (AHI)的关系。方法 15 9名欧洲白种OSAS鼾症患者。OSAS诊断标准为AHI>15次 /小时 ,AHI 15次 /小时者为鼾症。每位患者拍摄自然头位X线头颅侧位片 ,临床检查 (体重指数、颈围 )及多导睡眠仪检查。患者又依体重指数 (BMI)分组 ,BMI >2 5 2 5为正常 ,BMI >2 5为超重。统计分析为t检验 ,相关分析及多因素逐步回归。结果 OSAS及鼾症患者之间的体重指数及颈围大小无显著性差异。男性OSAS患者的软腭长度大于鼾症者。相关分析结果为AHI与患者的颈围、体重指数、下颌位置、下颌平面角相关。多因素回归分析结果表明在超重OSAS患者中AHI与颈围及下颌平面角相关 ,而体重正常的OSAS患者 ,AHI与气道宽度、软腭长度相关。超重OSAS患者按性别分组后 ,男性组AHI与体重指数相关 ,女性组AHI与颈围大小相关。结论 在OSAS与鼾症患者之间存在一些气道结构上差异。男性、女性及超重、正常体重AHI的不同的相关关系表明 ,它们之间存在一些病生理上的差异。

Objective To investigate the relationship between body mass index(BMI),neck size,craniofacial structure and the severity of sleep apnoea(OSAS).Method 159European white snoring and sleep apnoea patients were included into this study.OSAS was defined as AHI(apnoea hypopnea index)〉15/hr,patients whose AHI〈15 per hour were snorers.Each patient underwent lateral cephalogram,clinical exam (BMI and size) and polysomnography examination.11 cephalometric measurements were carried out.The patients were subdivided by BMI(body mass index),BMI25 was normal and BMI〉25 was considered overweight.T test,Pearson’s correlation coefficient and stepwise multiple regression analysis were used.Results No significance was found in BMI,age and neck size between sleep apnoea and snoring patients.In males the OSAS patients had longer soft palate than snorers. In the pearson’s correlation analysis, AHI showed a high level of significant correlation to neck size as well as correlating with BMI, B S’ and mandibular plane angle.In multiple stepwise regression analysis,AHI was correlated with the neck size and mandibular plane angle in OSAS overweight patients,whereas PAS and the length of soft palate were strongly correlated to the AHI in normal BMI sleep apnoea patients.AHI was highly correlated to BMI(p〈0.01)in overweight male OSAS group,and was strongly correlated to the neck size(p〈0.01)in the overweight female OSAS group.Conclusion There is some structure difference between OSAS patients and snorers The different correlations in normal and overweight,male and female subjects imply that there is possible different airway pathophysiology existing between them.