OSAHS患者颅面上气道形态特征及OSAHS与CAD相关性的研究

Study on the morphological characteristics of craniofacial and upper airway in OSAHS patients and the correlation between OSAHS and CAD

目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的颅面上气道形态特征,以及与冠心病(CAD)的相关性。方法:纳入186例疑似OSAHS的CAD患者,行冠状动脉造影、睡眠呼吸监测及拍摄头颅侧位片。依据睡眠呼吸暂停低通气指数(AHI)分为非OSAHS组(66例)和OSAHS组(120例),后者又分轻(35例)、中(43例)、重(42例)度亚组,对其颅面上气道头影测量结果及动脉粥样硬化评分(Gensini)进行比较分析。结果:OSAHS组SNB和SPAS下降(P<0.05),ANB、SPL、SPT、H-C3、H-MP上升(P<0.05)。Gensini评分非OSAH组最低,重度OSAH组最高(4组间比较,P<0.01)。AHI越大,冠状动脉狭窄越严重。结论:OSAHS患者有下颌后缩、软腭厚长、舌骨前下移位倾向,使上气道狭窄。OSAHS与CAD密切相关,AHI越大,冠状动脉狭窄越严重。

Objective:To investigate the morphological characteristics of craniofacial and upper airway in patients with obstructive sleep apnoea hypopnea syndrome(OSAHS)and the correlation between OSAHS and coronary artery disease(CAD).Methods:186 CAD patients with the suspection of OSAHS were included.According to apnea hypopnea index(AHI),the patients were divided into non-OSAHS group(n=66)and OSAHS group(n=120),and the latter was divided into mild(n=35),moderate(n=43)and severe(n=42)subgroups.Coronary angiography,home polysemnograph monitoring and lateral cephalogram were performed for the patients.The craniofacial and upper airway cephalometric measurements andatherosclerosis scores(Gensini scores)of were compared among groups.Results:In OSAHS group SNB and SPAS were lower,ANB,SPL,SPT,H-C3 and H-MP were higher in OSHAS group than those in non-OSAHS group(P<0.05).Gensini score of non-OSAHS group was the least,in sevever OSAHS group was the most(among the 4 groups,P<0.01).Conclusion:OSAHS patients had the tendency of mandibular retraction,thick and long soft palate,and anterior and inferior hyoid displacement,resulting in upper airway stenosis.OSAHS was closely related to CAD.Higher AHI is related with the stenosis of coronary artery.