128层螺旋CT对阻塞性睡眠呼吸暂停低通气综合征咽旁间隙脂肪及颌下脂肪的研究

Parapharyngeal and Underjaw Fat Tissue in Severe Obstructive Sleep Apnea Hypopnea Syndrome by Using 128-slice Spiral CT

目的探讨颈部咽旁间隙脂肪及颌下脂肪增多对重度男性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)发病的影响。资料与方法采用128层螺旋CT分别对52例重度OSAHS男性患者及年龄匹配的对照组32例正常成年男性行上气道扫描,比较两组咽旁间隙脂肪和颌下脂肪体积的差异,并与OSAHS严重程度(呼吸暂停低通气指数和平均血氧饱和度)进行相关性研究。结果与对照组相比,OSAHS组患者咽旁间隙和颌下脂肪体积均显著增加(P<0.05、P<0.001);OSAHS患者咽旁间隙和颌下脂肪体积与平均血氧饱和度均呈负相关(r=-0.344、-0.389,P<0.05),与呼吸暂停低通气指数无明显相关性(r=-0.077、0.096,P>0.05)。结论咽旁间隙脂肪及颌下脂肪堆积过多可能是OSAHS发病的重要因素,采用CT测量患者咽旁间隙脂肪及颌下脂肪体积对评估患者夜间平均血氧饱和度和辅助临床诊断具有重要作用。

Purpose To discuss the impact of increasing parapharyngeal and underjaw fat tissue on the onset of severe obstructive sleep apnea hypopnea syndrome（OSAHS） in male patients. Materials and Methods Fifty-two male cases with severe OSAHS and 32 age-matched normal males were included in the study, their upper airways were scanned by 128-slice spiral CT, fat tissue volume of the parapharyngeal and underjaw were compared and the correlation with the severity of OSAHS（apnea hypopnea index and mean Sa O2） was evaluated. Results Fat tissue volume of the parapharyngeal and underjaw were larger in patients with OSAHS than those of the controls（P〈0.05, P0.001）; significant negative correlations were found between these measurements and mean Sa O2 in OSAHS patients（r=- 0.344 and- 0.389, P〈0.05）, while no significant correlation was found with apnea hypopnea index（r=-0.077 and 0.096, P〈0.05）. Conclusion The excessive accumulation of parapharyngeal and underjaw fat tissue may be an important factor in the onset of OSAHS, using CT to measure their volume could play an important role in evaluation of overnight mean Sa O2 and assisting clinical diagnosis.