鼻底解剖特征与阻塞性睡眠呼吸暂停低通气综合征的相关性分析

Relationships between the characteristics of the anatomy of the basis nasi and the severity of obstructive sleep apnea hypopnea syndrome

目的分析鼻底及相关上气道解剖特征与阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSA HS)的相关性。方法 50例OSAHS患者和40例对照组研究对象均接受多道睡眠图监测及上呼吸道三维CT检查。对比组间各参数差异,分析上气道解剖特征与睡眠监测参数间的相关性。结果两组间多个CT指标均具有显著性的差异,包括腭咽腔与舌咽腔的最小左右径及最小截面积、腭咽腔的最小前后径以及鼻底气道宽度(P均<0.05)。logistic回归分析提示腭咽最小截面积及鼻底气道宽度是OSAHS发生与否的独立预测因素(风险比值比分别为0.978及0.589,P<0.05)。相关分析提示鼻底气道宽度及鼻底气道面积均与多项咽腔CT指标显著相关(P<0.05),其中二者与腭咽腔最小截面积的相关系数分别为0.536及0.425。结论鼻底及腭咽腔狭窄是OSAHS发生的独立解剖危险因素,鼻底部位的气道特征与下游咽腔的解剖特征相关。

OBJECTIVE To investigate the relationships between the characteristics of the upper airway anatomy,including the basis nasi,and the severity of obstructive sleep apnea hypopnea syndrome(OSAHS).METHODS Fifty OSAHS patients and 40 normal subjects received three-dimensional CT scan and poly somnography(PSG).Variables between the two groups were compared.The association between the PSG parameters and the upper airway anatomic features were analyzed.RESULTS There were significant differences in several CT variables between OSAHS patients and normal subjects(P<0.05),including the minimal lateral airway dimension and the minimal cross-sectional airway area of both velopharynx and glossopharynx,the minimal anteriorposterior airway dimension of velopharynx,and the airway width of basis nasi.The result of logistic regression analysis suggested that the minimal cross-sectional airway area of velopharynx and the airway width of basis nasi were significant predictors of the OSAHS(P<0.05,the values of the odds ratio were 0.978 and 0.589).The correlation analysis suggested that the airway width and the airway area of basis nasi both correlated significantly with several CT variables of pharynx(P<0.05),among these results,the correlation coefficents between these two variables and the mCSA of velopharynx were 0.536 and 0.425 respectively.CONCLUSION Narrowed basis nasi and velopharynx might be important anatomical features in OSAHS patients.There are correlations between the characteristics of basis nasi and the anatomy of pharyngeal airway.