阻塞性睡眠呼吸暂停低通气综合征患者的上气道CT影像学特征分析

Upper Airway CT Imaging Features Analysis of the Obstructive Sleep Apnea Hypopnea Syndrome Patients

为比较阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者与正常健康者的上气道结构差异，本研究选取了OSAHS患者47例（OSAHS组1，其中轻度OSAHS患者15例、中度OSAHS患者20例，重度OSAHS患者12例；同时选取正常健康者50例作为对照组，均采用螺旋CT进行扫描分析。研究发现OSAHS组软腭悬雍垂后区容积和咽腔总容积分别为（4．58±1．55）mL$N（14．84±3．14）mL，明显低于对照组（p〈0.05），而上颌窦容积为（34．01±5．68）mL，明显高于对照组（p〈0．05）；OSAHS组软腭游离缘平面和舌后区平面咽壁顺应性分别为（0．85±0．20）和（0.77±0．18），明显高于对照组（p〈0．05）；不同程度OSAHS患者软腭悬雍垂后区容积、咽腔总容积、上颌窦容积以及软腭游离缘平面和舌后区平面咽壁顺应性比较差异有统计学意义（p〈0.05）。本研究表明，螺旋CT扫描可用于对咽腔、上颌窦以及口咽部各平面咽壁顺应性的评估，其中OSAHS患者咽腔容积明显低于健康者，而咽壁顺应性和上颌窦容积明显高于健康者，这为临床诊断与治疗提供了客观依据。

To compare the structural differences of upper airway between obstructive sleep apnea hypopnea synd- rome （OSAHS） patients and normal healthy subjects, 47 patients with OSAHS were selected in this study, of which 15 patients with mild OSAHS, 20 patients with moderate OSAHS and 12 patients with severe OSAHS; 50 healthy subjects were selected as control group, and all were scanned and analyzd by spiral CT. It was showed that soft palate uvula posterior volume and total pharyngeal cavity volume of the OSAHS group were （4.58±1.55） mL and （14.84±3.14） mL respectively, which were significantly lower than that of the control group （p〈0.05）; and the maxillary sinus volume was （34.01±5.68） mL, which was significantly higher than that of the control group （p 〈0.05）; in OSAHS group, the pharynx wall resilience of the free edge plane in the soft palate and the plane of retropharyngeal region were 0.85±0.20 and 0.77±0.18, which were significantly higher than that of the control group （p〈0.05）; there were significant differences in the volume of the soft palate uvula posterior, the total volume of the pharyngeal cavity, the volume of the maxillary sinus, the pharynx wall resilience of the free edge plane in the soft palate and the plane of the lingual area in patients with different degrees of OSAHS （p〈0.05）. It indicated that spiral CT scan could evaluate the pharyngeal cavity, maxillary sinus and pharynx wall resilience of oropharyngeal planes. Pharyngeal cavity volume in OSAHS patients was significantly lower than that of healthy subjects, pharynx wall resilience and maxillary sinus volume were significantly higher than those of healthy subjects, which could provide an objective basis for clinical diagnosis and treatment.