STOP-BANG问卷与下颌骨宽度及上气道不同层面CT测量对OSAHS患者严重性的评估

Combination of STOP-BANG questionnaire,mandibular width and upper airway CT measurement at different levels to evaluate the severity of OSAHS

目的探讨STOP-BANG问卷(SBQ)、下颌骨宽度及上气道不同层面CT测量对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)筛查的临床价值。方法选择2020年9月—2021年5月在柳州市人民医院耳鼻咽喉头颈外科就诊的疑似OSAHS患者60例,进行SBQ、下颌骨宽度测量、上气道多平面CT测量,同期多导睡眠图(PSG)监测。结果根据睡眠呼吸暂停低通气指数(AHI)将研究对象分为非OSAHS组、轻中度组、重度组3组;3组间性别、年龄无统计学差异;3组间SBQ、下颌骨宽度、软腭冠矢状径等比较,具有统计学意义(P<0.05);重度OSAHS组SBQ分数明显高于轻中度组和非OSAHS组(P<0.05),Logistic回归分析发现SBQ分数、下颌骨宽度为OSAHS独立危险因素,下颌骨宽度联合SBQ诊断与单一SBQ作为诊断指标相比,可提高OSAHS初步筛查的灵敏度。结论SBQ分数、下颌骨宽度、软腭后区冠矢状径、悬雍垂及舌后区冠状径均与OSAHS患者病情严重程度密切相关;SBQ联合下颌骨宽度测量有助于OSAHS初筛,适合于门诊和手术患者OSAHS风险筛查。

Objective To explore the clinical value of STOP-BANG questionnaire(SBQ),mandibular width and CT measurements at different levels of upper airway for obstructive sleep apnea hypopnea syndrome(OSAHS)screening.Methods Sixty suspected OSAHS patients who were admitted to the Department of Otorhinolaryngology,Liuzhou People’s Hospital from Sept 2020 to May 2021 were included.All the patients underwent SBQ,mandibular width measurement,upper airway CT measurement and polysomnography(PSG).Results All the subjects were divided into three groups according to sleep apnea hypopnea index(AHI):Non-OSAHS group,mild to moderate OSAHS group,and severe OSAHS group.The differences in gender and age among the three groups were statistically insignificant.There were significant differences in SBQ score,mandibular width,coronal and sagittal diameters of soft palate among the three groups(all P<0.05).The SBQ score of the severe OSAHS group was significantly higher than those of the mild to moderate and non-OSAHS groups(both P<0.05).Logistic regression analysis found that SBQ score and mandible width were independent risk factors for OSAHS.Compared with single SBQ as a diagnostic index,mandibular width combined with SBQ could improve the sensitivity of preliminary screening in OSAHS.Conclusions SBQ,mandibular width,sagittal and coronal diameters of the retropalatal region,coronal diameters of uvula and retroglottal region are closely related to the severity of OSAHS.SBQ combined with mandibular width measurement is helpful for preliminary screening of OSAHS and is suitable for OSAHS risk screening in outpatients and surgical patients.