维吾尔族OSAHS患者X线头影测量与上气道测压的临床研究

Clinical research on X-ray cephalometrics and upper airway pressure measurement in Uygur OSAHS patients

目的探讨在新疆维吾尔族男性重度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者术前阻塞平面定位中X线头影测量的腭后间隙(Uvula-middle pharyngeal wall,U-MPW)及舌后间隙(posterior airway space,PAS)与上气道测压系统(Apnea Gragh,AG)判定阻塞平面构成比的关系,为外科治疗上气道狭窄提供较准确的参考依据。方法选取24例经多导睡眠监测(polysomnoaphy,PSG)确诊的维吾尔族男性重度OSAHS患者,均完善AG及X线头影测量检查,将AG判定腭咽上、下平面阻塞的构成比与U-MPW及PAS值进行相关性分析。结果本组中AG判定腭咽上平面阻塞构成比超过50%的患者(剔除合并鼻腔及鼻咽部病变),其构成比与U-MPW呈直线相关(r=-0.544,p<0.05);AG判定腭咽下平面阻塞的构成比超过30%的患者(剔除双侧扁桃体及咽侧索过度肥大和小下颌畸形),其构成比与PAS呈较好的负相关关系(r=-0.543,p<0.05)。结论在维吾尔族男性重度OSAHS患者术前阻塞平面定位中,排除鼻腔、鼻咽部病变及双侧扁桃体过度肥大影响,AG与X线头影测量判定阻塞平面的一致性较好。

Objective To discuss the correlation between Uvula-middle pharyngeal wall（U-MPW） or posterior airway space（PAS）using X-ray cephalometrics and the constituent ratio determined by Apneagragh（AG） in the Xinjiang Uygur male patients with severe obstructive sleep apnea hypopnea syndrome（OSAHS）,so as to provide a more accurate reference for surgical treatment of upper airway caliber.Methods 24 Uygur male patients who were diagnosed with severe OSAHS by polysomnography（PSG） were done with AG study as well as preoperative cephalometric analysis.A correlation analysis was performed between the percentage of upper or lower level obstructions by AG and U-MPW or PAS evaluated by cephalometric analysis.Results The constituent ratio more than 50%（exclude nasal cavity and nasopharynx diseases） had a negative linear correlation with the data of U-MPW（r=-0.544,p0.05）,and the constituent ratio more than 30% in the lower level obstructions（exclude bilateral lateral pharyngeal and tonsil hypertrophy and micrognathia） had a negative linear correlation with the data of PAS（r=-0.543,p0.05）.Conclusion When nasal and nasopharyngeal diseases and bilateral tonsil hypertrophy were excluded,AG and X-ray cephalometrics can be used to determine preoperative localization of obstructive space in the Uygur male patients with severe OSAHS.