肥胖伴OSAHS患者X线头影测量研究

Cephalometric Analysis on the Obese Patients with OSAHS

目的分析肥胖伴OSAHS患者头影软硬组织的测量特征。方法采用本科开发的OSAHS患者计算机头影测量分析系统,对67例年龄在40～60岁、BMI≥30以上的OSAHS患者(诊断经nPSG监测确立,患者AHI≥5)和12例同年龄组的正常人头影软硬组织进行测量对照分析。结果本组肥胖伴OSAHS患者头影硬组织测量特征表现为下颌骨后缩,舌骨向后下移位;软组织测量特征上表现为舌、软腭矢状面积显著增加,舌、软腭占口咽腔比明显增加,软腭后和舌后咽径明显减小。口咽部狭窄(软腭和舌后区)最多见(54.02%),软腭水平咽腔阻塞占29.89%,上、中、下咽腔同时阻塞为1.15%,87.35%肥胖伴OSAHS患者存在上气道狭窄,72.41%患者为多部位阻塞。结论大部分肥胖伴OSAHS患者头影硬组织测量存在异常,此类患者睡眠时上气道通气不畅多发生于口咽区,大部分患者为多部位狭窄或阻塞。

Objective To study the characteristics of the cephalometric analysis of obese patients with OSAHS. Methods 67 obese patients with OSAHS that their body mass index (BMI) was bigger than 30 and their AHI was over 5 by PSG were examined by cephalometric analysis, meanwhile 12 normal control were evaluated by same cephalometric analysis methods. Their age was from 40 to 60 years old. Results There were some characterisitics on the patients of obese patients with OSAHS. Their SNB was remarkably decreased and their position of hyoid bone was lower and more posterior. In term of the cephalometric analysis of the soft tissue around the upper airway, their sagital areas of tongue and soft palate remarkably increased, so did the rates of their area vs. oral-pharyngeal area. The narrow site was observed at the regions behind soft palate and tongue base, the rate was 54.02%. The single narrow site at the region behind soft palate was 29.89%. The narrow site occurred at all over of upper airway was 1.15%. There were 87.35% patients existed the narrow of the upper airway, and 72.41% patients were multipoint narrow in their upper airway. Conclusions The patients of obese patients with OSAHS are mostly abnormal on cephalometric analysis and their upper airway. These patients have multipoint narrow in their upper airway,the most common site is at the regions behind soft palate and tongue base.