Tong M, Sakakibara H, Xia X, Suetsugu S
Department of Respirology, General Hospital of Nanjing Army, Nanjing 210002.
J Tongji Med Univ. 2000;20(1):66-9. doi: 10.1007/BF02887681.
The upper airway narrowing and changes in head posture and their relationship with apnea severity in patients with obstructive sleep apnea (OSA) were investigated. In 86 male OSA patients and 37 healthy men, one-night polysomnographic examination was performed and a lateral cephalogram by digital image processing system was taken in each subject. Fifteen variables concerning the upper airway dimensions, area and head postures were measured by using a computer software (NIH Image). The results showed that upper airway dimensions in the OSA group at all levels were significantly smaller than those in the control group and the results hold true when the age and body mass index were well controlled in these two groups. Significant forward inclination of the cervical column was found in the patients with an apnea index (AI) greater than 35 episodes/h. And changes in the head posture variables in the whole study group were significantly correlated with AI and airway dimensions at various levels. It was suggested that there exist significant and extensive upper airway narrowing in OSA patients even in upright position and awake state; And as the apnea severity progresses, patients may assume certain compensatory head postures in an attempt to maintain an adequate airway patency.
对阻塞性睡眠呼吸暂停（OSA）患者上气道狭窄、头部姿势变化及其与呼吸暂停严重程度的关系进行了研究。对86例男性OSA患者和37名健康男性进行了一晚的多导睡眠图检查，并使用数字图像处理系统为每位受试者拍摄了一张头颅侧位片。使用计算机软件（NIH Image）测量了15个与上气道尺寸、面积和头部姿势有关的变量。结果显示，OSA组各级上气道尺寸均显著小于对照组，且在两组年龄和体重指数得到良好控制时，结果依然成立。呼吸暂停指数（AI）大于35次/小时的患者中发现颈椎明显前倾。整个研究组的头部姿势变量变化与AI及各级气道尺寸显著相关。提示OSA患者即使在直立位和清醒状态下也存在显著且广泛的上气道狭窄；并且随着呼吸暂停严重程度的进展，患者可能会采取某些代偿性头部姿势以试图维持足够的气道通畅。
