药物诱导睡眠内镜和上气道CT检查在阻塞性睡眠呼吸暂停低通气综合征患者中的应用比较

A comparison of the application of drug-induced sleep en doscopy and upper airway computed tomography to diagnose ptaients with obstructive sleep apnea-hypopnea

目的：探讨中重度阻塞性睡眠呼吸暂停低通气综合征（ OSAHS）患者药物诱导睡眠内镜（ DISE）和上气道CT（ UACT）检查结果之间的关联，评价UACT的临床应用价值。方法对57例经多导睡眠监测确诊的中重度OSAHS患者分别行UACT及DISE检查。依据DISE结果将患者分为非完全阻塞组和完全阻塞组（气道塌陷度＜75％为非完全阻塞，≥75％为完全阻塞）。对UACT所获图像进行数据处理，测量气道截面积、前后径和左右径，比较两组的差异。结果根据DISE 检查，57例患者（均为男性）中73．7％（42／57）存在腭咽部位完全阻塞，70．2％（40／57）有口咽部完全阻塞，61．4％（35／57）有舌根部完全阻塞，59．7％（34／57）有会厌部完全阻塞。非完全阻塞组和完全阻塞组通过UACT测得的腭咽和口咽部前后径值以及腭咽、口咽和会厌部截面积值的差异有统计学意义（P＜0．05），其余测量结果的差异均无统计学意义（P＞0．05）。结论 UACT中腭咽、口咽部的前后径和腭咽、口咽、会厌部的截面积对评估中重度OSAHS患者气道阻塞程度有一定价值。

Objetcive To investigate the relationship between the examination results of patients with obstructive sleep apnea-hypopnea syndrome（ OSAHS） by drug-induced sleep endoscopy （ DISE） and upper airway computed tomography （ UACT） and to evaluate the application of UACT in clinical setting .Mtehods A total of 57 male patients who were diagnosed with moderate/severe OSHAS by polysomnography underwent UACT and DISE .According to DISE results, the patients were divided into a non-complete obstruction group （〈75%airway collapse） and a complete ob-struction group （ 75%airway collapse） .Meanwhile, both groups were compared for pharyngeal cross-sectional area, anteroposterior diameter and lateral diameter according to UACT images obtained.Results According to DISE results, 73.7%of the patients （42/57） presented complete obstruction at velum, 70.2%（40/57） showed complete oropharyn-geal obstruction, 61.4% （35/57） manifested complete obstruction at the base of tongue , and 59.7% （34/57） had complete blockage of the epiglottis.The complete/non-complete obstruction groups presented statistical significances in the anteroposterior diameter at velum and oropharynx （ P〈0.05） , and in the cross-sectional area at velum, oropharynx and epiglottis （P〈0.05）.Concl usion Measurement of anteroposterior diameter at velum and oropharynx and cross-sectional area at velum, oropharynx and epiglottis can be applied for assessment of airway obstruction in patients with moderate to severe OSAHS.