不同特征儿童上气道结构发育情况分析

Analysis of upper airway structure development in children with different characteristics

目的分析不同特征儿童上气道发育情况。方法将2018年6月至2020年6月于首都儿科研究所附属儿童医院行头颅MRI检查且未患睡眠呼吸障碍的425例16岁及以下儿童纳入研究。于正中矢状面MRI图像上测量软腭、舌、上气道、颏棘-斜坡长度、腺样体厚度和鼻咽腔宽度等参数,比较不同年龄组内各上气道参数间的性别差异,分析上气道参数与年龄的相关性。结果婴儿组、幼儿组、学龄前组、学龄期组和青少年组分别为80、86、90、90和79例;男童219例(51.5%)。学龄前组男性腺样体厚度为(1.26±0.26)cm,高于女性[(1.15±0.20)cm](P=0.025);青少年组男性上气道长度[(5.89±0.60)cm]和上气道长度/颏棘-斜坡长度比值(0.73±0.08)高于女性[分别为(5.31±0.45)cm和0.67±0.07](均P<0.05)。各年龄组男女其他上气道参数差异均无统计学意义(均P>0.05)。上气道长度、颏棘-斜坡长度、舌长度、软腭长度、鼻咽腔宽度和腺样体厚度均与年龄呈正相关,r值分别为0.932、0.912、0.898、0.705、0.734和0.168,均P<0.05。腺样体厚度出生至5岁时与年龄呈正相关(r=0.603,P<0.001),≥6岁儿童与年龄呈负相关(r=-0.259,P=0.001)。结论儿童上气道结构发育存在年龄和性别差异。

Objective To analyze the development of upper airway in children with different characteristics.Methods From June 2018 to June 2020,a total of 425 children younger than 16 years old who underwent head MRI examination and did not have sleep-disordered breathing were included in the study.The length of soft palate,tongue,upper airway,mental spine clivus,adenoid thickness and nasopharyngeal width were measured in the midsagittal plane of MRI image.Single factor variance analysis was used to compare the gender differences of upper airway parameters within certain age groups.Pearson correlation analysis was used to analyze the correlation between upper airway parameters and age.Results The numbers of subjects in infant,young child,preschool,school age and adolescent group were 80,86,90,90 and 79,respectively.There were 219 males,accounting for 51.5%of the study population.The adenoid thickness in the preschooler group was(1.26±0.26)cm,higher than that in the female group(1.15±0.20)cm(P=0.025).The upper airway length(5.89±0.60)cm and the ratio of upper airway length/mental spine-slope length(0.73±0.08)in males were higher than those in females[(5.31±0.45)cm and 0.67±0.07,respectively,P<0.05].There was no gender difference in other upper airway parameters among different age groups(all P values>0.05).The length of upper airway,mental spine-slope,tongue,soft palate,the width of nasopharyngeal cavity and the thickness of adenoids were positively correlated with age(r=0.932,0.912,0.898,0.705,0.734 and 0.168,respectively),all P values<0.05.Adenoid thickness was positively correlated with age from birth to age 5 years(r=0.603,P<0.001),and negatively correlated with age after age 6 years(r=-0.259,P=0.001).Conclusion There are gender differences in the development of upper airway structure in children of different ages.