阻塞性睡眠呼吸暂停中舌根与软腭阻塞的比较。

Comparison between tongue base and soft palate obstruction in obstructive sleep apnea.

作者信息

Kim Jeong-Whun, Yoon In Young, Chung Seockhoon, Lee Chul Hee, Moon Sung Joong, Yun Pil Young

机构信息

Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

出版信息

Acta Otolaryngol. 2009 Aug;129(8):855-61. doi: 10.1080/00016480802443677.

DOI:10.1080/00016480802443677

PMID:18979268

Abstract

CONCLUSIONS

In obstructive sleep apnea syndrome (OSAS), respiratory disturbances are more serious in tongue base-associated obstructions (TBOs) than in soft palate-associated obstructions (SPOs), and the proportion of TBO was predicted by average duration of apnea and hypopnea, and inversely by percentage time of snoring.

OBJECTIVE

To compare the polysomnographic characteristics of two main obstruction sites of OSAS, the soft palate and tongue base, and to identify those variables correlated with tongue base obstructions in patients with OSAS.

PATIENTS AND METHODS

Thirty-one patients (28 men and 3 women) with OSAS were enrolled in this study. To identify airway obstruction levels upper airway pressure manometry was applied during polysomnography. Airway obstructions were categorized as SPO and TBO by observing pressure patterns. All analyses of events were performed in the supine position.

RESULTS

Average duration of apnea and hypopnea, percentage of apnea among apnea-hypopneas, average O(2) desaturation, and percentage of event-related arousals were significantly higher in TBOs compared with SPOs (all p<0.05). The percentage of TBO among total obstructions (TBO%) was independently associated with average duration of apnea and hypopnea (=0.38, p<0.05) and percentage time of snoring (=-0.44, p<0.01) (adjusted R(2)=30%, p<0.01).

摘要

结论

在阻塞性睡眠呼吸暂停综合征（OSAS）中，舌根相关性阻塞（TBO）引起的呼吸紊乱比软腭相关性阻塞（SPO）更严重，TBO的比例可通过呼吸暂停和低通气的平均持续时间进行预测，且与打鼾时间百分比呈负相关。

目的

比较OSAS两个主要阻塞部位（软腭和舌根）的多导睡眠图特征，并确定与OSAS患者舌根阻塞相关的变量。

患者与方法

本研究纳入了31例OSAS患者（28例男性和3例女性）。为确定气道阻塞水平，在多导睡眠监测期间应用上气道压力测定法。通过观察压力模式将气道阻塞分为SPO和TBO。所有事件分析均在仰卧位进行。

结果

与SPO相比，TBO的呼吸暂停和低通气平均持续时间、呼吸暂停 - 低通气中呼吸暂停的百分比、平均氧饱和度下降以及事件相关觉醒的百分比均显著更高（所有p<0.05）。总阻塞中TBO的百分比（TBO%）与呼吸暂停和低通气的平均持续时间（=0.38，p<0.05）以及打鼾时间百分比（=-0.44，p<0.01）独立相关（调整后R² = 30%，p<0.01）。