阻塞性睡眠呼吸暂停低通气综合征患者腭舌比值与症状程度的相关性分析

The correlation analysis between the ratio of palate tongue and symptom in patients with obstructive sleep apnea hypopnea syndrome

目的探讨软腭长度与舌体厚度比值的大小和阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者症状轻重高低的关系,并与传统Friedman分型比较。方法纳入研究的OSAHS患者110名,均采用螺旋CT自前颅底至甲状软骨水平区域进行连续扫描,选取硬腭正中矢状位三维重建图像分析,应用计算机辅助测图工具测量硬腭后缘至悬雍垂尖端长度,以及颏嵴至舌中后1/3交接点(即舌盲孔处)舌体厚度,并计算软腭长度与舌体厚度比值。分析该比值与多导睡眠呼吸监测(PSG)检查结果的关系,并与Friedman分型比较。结果 1软腭长度与舌体厚度比值与OSAHS病情严重程度低通气指数(AHI)数值呈显著正相关(r=0.313,P=0.001);与Friedman分型呈负相关(r=-0.196,P=0.041);2在不同AHI分度组间比较,软腭长度与舌体厚度比值有显著差异(F=3.478,P=0.019);3在不同Friedman分型组间比较,软腭长度与舌体厚度比值有显著差异(t=2.131,P=0.035)。4多元逐步回归分析证实软腭长度与舌体厚度比值是AHI大小的显著影响因素(R=0.265,F=19.333,P=0.001)。结论 OSAHS患者AHI与软腭长度与舌体厚度的比值呈明显正相关性,即随软腭长度与舌体厚度的比值增大,OSAHS病情严重程度也增加,同时其与传统Friedman分型有一定的一致性。

Objective To analyze the correlation between the palate/tongue （P/T）ratio and the severity of obstructive sleep apnea hypopnea syndrome （OSAHS）patients with symptoms of level,and make a comparison of P/T ratio with Friedman stage.Methods One hundred and ten patients with OSAHS who were referred to our hospital between De-cember 2010 and August 2012,were enrolled in this study.Computed tomography （CT）scans were performed from the skull base to the thyroid cartilage,and the middle and sagittal reconstruction images of the pharyngeal region were obtained.The length of the soft palate means the distance from the base of the soft palate to the tip of the uvula,and the lingual thickness means the distance from the genial tubercle to the foramen cecum linguae.The P/T ratios of length of the soft palate to the lingual thickness were measured.Finally,we analyzed the correlation between P/T ratio and apnea hypopnea index （AHI）and compared the P/T ration and Friedman Stage.Results ①The P/T ratio had significantly positive correlation with AHI（r=0.313,P=0.001）and had negative correlation with Friedman stage （r=-0.196, P=0.041）.② The P/T ratios had significant differences among different severity OSAHS groups（F=3.478,P=0.019）.③ The P/T ratios had significant differences among different Friedman stage groups（t=2.131,P=0.035）.④ The multinomial step regression analysis showed that the P/T ratios was the most important factor of AHI （R=0.265,F=19.333,P〈0.001）.Conclusion The P/T ratio had significantly positive correlation with AHI in OSAHS patients.When P/T ratio increased,the severity of OSAHS also increased.Meanwhile,P/T ratio has a certain consistency with the Friedman stage.