中重度OSAHS患者舌体MRI与上气道测压舌后区阻塞的相关性分析

The analysis of correlation between tongue body MRI and upper airway pressure measurements of blocked lingual region in patients with moderate and severe OSAHS

目的:探讨OSAHS患者舌体MRI测量值与舌后区阻塞的相关性,判断二者在阻塞平面定位诊断中的关系,以提高术前对OSAHS患者阻塞平面诊断的准确性。方法:对经AG200睡眠呼吸监测及阻塞平面定位系统确诊的符合纳入标准的59例OSAHS患者行舌体MRI检查并进行三维重建,利用计算机系统测出舌体长径、相对厚度,基底部左右宽径、中部左右宽径及舌体体积。将AG200确定的下部阻塞(主要为舌后区)构成比P与舌体MRI检查所测得各测量参数做相关性分析,同时分析不同程度OSAHS患者下部阻塞构成比之间的差异。结果:59例患者舌体长径、相对厚度、基底部左右宽径、中部左右宽径及舌体体积与下部阻塞构成比P之间的相关系数分别为rLP=0.051,rHP=0.069,r1=0.215,r2=0.147,rVP=0.259,不同程度OSAHS患者下部阻塞构成比之间均差异有统计学意义(P<0.05)。可见舌体各测量参数均与下部阻塞构成比P呈负相关,说明在排除了喉部及喉咽部狭窄的前提下,经AG200测得的下平面狭窄与舌体MRI测得的各参数均有关系,与舌体体积相关性最强。结论:舌体体积与AG对下部阻塞的判定有明显相关性趋势,OSAHS患者下部阻塞构成比之间随病情严重程度而变化,两者结合可作为预测OSAHS患者睡眠时上气道阻塞平面的参考,可为OSAHS治疗的个体化提供依据。

Objective：To investigate the correlation between tongue body MR1 measurements and the lingual region obstruction in patients with obstructive sleep apnea hypopnea syndrome （obstructive sleep apnea hypopnea syndrome, OSAHS）, and the relationship of two diagnosis methods in positioning obstructive level, in order to improve the preoperative diagnostic accuracy of obstructive level in OSAHS patients . Method.. Fifty-nine patients with OSAHS definited by the AG200 sleep apnea monitoring and obstruction plane positioning system was included. They all underwent tongue MRI scan, after three-dimensional reconstruction, the tongue body length to diam- eter, relative thickness, basal diameter, wide around central about wide diameter and tongue body volume were measured. The lower blocking （mainly composed of lingual region） constituent ratio P established by AG200 was correlated with tongue parameters measured by MRI. At the same time, To analysis of differences of P in patients with different degree of OSAHS. Result： Among these patients with OSAHS in different degree, the coefficient correlation between tongue parameters（tongue length, relative thickness, basal diameter, wide middle diameter , tongue body volume） and lower blocking constitute ratio P werer Lp =0. 051,r HP =0. 069, r1 =0. 215, r2 =0. 147, rvp =0. 259, respectively, lower obstruction of form than the differences had statistical significance. The measured tongue parameters and value P（the lower blocking constituent ratio） were negatively correlated, which demonstrated that exclusing of the larynx and hypopharynx airway obstruction, the lower airway obstruction detected by AG200 was related with tongue parameters measured by MRI, and was strongestly related with the tongue body volume. Conclusion：The volume of tongue and AG had correlation in judgement of lower blocking. In OSAHS patients the lower blocking constituent ratio varies between the defferent severity groups of the disease, the combination of the two method can be used to predict the obstructive plane in OSAHS patients with upper airway obstruction, and provide the basis for the individual treatment of patients with OSAHS.