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[阻塞性睡眠呼吸暂停低通气综合征患者的咽部大小与可塌陷性]

[Pharyngeal size and collapsibility in patients with obstructive sleep apnea hypopnea syndrome].

作者信息

Yu Yan-xia, Guo Xi-heng

机构信息

Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital University of Medical Sciences, Beijing 100020, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2005 Nov 23;85(44):3110-4.

Abstract

OBJECTIVE

To study the pharyngeal cross-sectional area and collapsibility among the patients with obstructive sleep apnea hypopnea syndrome (OSAHS), simple snorers, and normal persons.

METHODS

171 patients with OSAHS, 44 with mild, 51 with moderate, and 56 with severe OSAHS, 47 simple snorers, and 47 healthy subjects underwent upper airway cross-sectional area measurement using acoustic pharyngometer at the conditions of functional residual capacity (FRC) and residual volume (RV) in the upright sitting position.

RESULTS

When the lung volume decreased from the condition of FRC to the condition of RV the pharyngeal cross-sectional area decreased from 2.63 cm(2) +/- 0.42 cm(2) to 1.96 cm(2) +/- 0.35 cm(2) for the simple snorers, 2.70 cm(2) +/- 0.44 cm(2) to 1.78 cm(2) +/- 0.39 cm(2) for the mild OSAHS patients, from 2.62 cm(2) +/- 0.52 cm(2) to 1.79 cm(2) +/- 0.37 cm(2) for the moderate OSAHS patients, and from 2.57 cm(2) +/- 0.46 cm(2) to 1.75 cm(2) +/- 0.40 cm(2) for the severe OSAHS patients, all with higher decrease rates (33.93% +/- 11.81%, 31.13% +/- 10.76%, and 31.31% +/- 13.44%) than that of the normal persons (25.07% +/- 10.39%), smaller than that for the normal persons (21.11% +/- 8.19%, from 3.05 cm(2) +/- 0.6 cm(2) to 2.38 cm(2) +/- 0. 47 cm(2), all P < 0.05). The change ratios of the 3 OSAHS groups were significantly higher than that of the simple snorer group (all P < 0.01). This indicated that the pharynges of OSAHS patients were more collapsible.

CONCLUSION

Snorers with or without apnea have smaller pharyngeal cross-sectional area than nonsnorers. The collapsibility of the upper airway is greater in both OSHAS patients and simple snorers than in healthy subjects.

摘要

目的

研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者、单纯打鼾者和正常人的咽部横截面积及可塌陷性。

方法

171例OSAHS患者,其中轻度44例、中度51例、重度56例,47例单纯打鼾者和47例健康受试者,在直立坐位功能残气量(FRC)和残气量(RV)条件下,使用声学咽测量仪测量上气道横截面积。

结果

当肺容积从FRC状态降至RV状态时,单纯打鼾者的咽部横截面积从2.63 cm²±0.42 cm²降至1.96 cm²±0.35 cm²,轻度OSAHS患者从2.70 cm²±0.44 cm²降至1.78 cm²±0.39 cm²,中度OSAHS患者从2.62 cm²±0.52 cm²降至1.79 cm²±0.37 cm²,重度OSAHS患者从2.57 cm²±0.46 cm²降至1.75 cm²±0.40 cm²,所有下降率(33.93%±11.81%、31.13%±10.76%和31.31%±13.44%)均高于正常人(25.07%±10.39%),小于正常人(21.11%±8.19%,从3.05 cm²±0.6 cm²降至2.38 cm²±0.47 cm²,均P<0.05)。3个OSAHS组的变化率均显著高于单纯打鼾者组(均P<0.01)。这表明OSAHS患者的咽部更易塌陷。

结论

有或无呼吸暂停的打鼾者咽部横截面积均小于非打鼾者。OSHAS患者和单纯打鼾者上气道的可塌陷性均大于健康受试者。

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