Susarla Srinivas M, Abramson Zachary R, Dodson Thomas B, Kaban Leonard B
Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA 02114, USA.
J Oral Maxillofac Surg. 2010 Nov;68(11):2846-55. doi: 10.1016/j.joms.2010.06.196.
The purpose of this study was to measure upper airway length (UAL) on lateral cephalograms and to assess its relationship with the presence and severity of obstructive sleep apnea (OSA).
Using a case-control study design, the investigators enrolled a sample of cases defined as adult subjects with OSA and controls who were adult patients with skeletal Class II malocclusions. The primary predictor variable was UAL. Other variables were demographic and cephalometric parameters. The respiratory disturbance index (RDI) was used to measure disease severity in cases. Bivariate analyses were computed to evaluate the associations between predictor and outcome variables. Multiple regression analyses were used to provide adjusted measures of association, controlling for the effects of confounders/effect modifiers. Diagnostic test characteristics were computed for threshold airway lengths. P ≤ .05 was considered statistically significant.
The sample consisted of 96 cases with OSA (76 males) and 56 controls without OSA (36 males). OSA subjects were older, were predominately male, and had higher body mass indexes and longer and narrower airways (P < .05). After controlling for confounding variables, UALs ≥ 72 mm for males and ≥ 62 mm for females were significantly associated with the presence of OSA (P = .03). The sensitivity and specificity of UAL as a diagnostic test for OSA were ≥ 0.8. UAL was strongly correlated with RDI (disease severity) in males (r = 0.72, P < .01) and moderately correlated with RDI in females (r = 0.52, P < .01).
Increased upper airway length was correlated with the presence and severity of OSA in this sample of adult patients.
本研究旨在测量头颅侧位片上的上气道长度（UAL），并评估其与阻塞性睡眠呼吸暂停（OSA）的存在及严重程度之间的关系。
采用病例对照研究设计，研究者纳入了一组被定义为患有OSA的成年受试者病例样本以及作为对照的患有骨骼II类错牙合畸形的成年患者。主要预测变量为UAL。其他变量为人口统计学和头影测量参数。呼吸紊乱指数（RDI）用于测量病例中的疾病严重程度。进行双变量分析以评估预测变量与结果变量之间的关联。采用多元回归分析来提供调整后的关联度量，控制混杂因素/效应修饰因素的影响。计算阈值气道长度的诊断测试特征。P≤0.05被认为具有统计学意义。
样本包括96例OSA病例（76例男性）和56例无OSA的对照（36例男性）。OSA受试者年龄更大，以男性为主，体重指数更高，气道更长且更窄（P<0.05）。在控制混杂变量后，男性UAL≥72mm且女性UAL≥62mm与OSA的存在显著相关（P = 0.03）。UAL作为OSA诊断测试的敏感性和特异性≥0.8。男性中UAL与RDI（疾病严重程度）强烈相关（r = 0.72，P<0.01），女性中UAL与RDI中度相关（r = 0.52，P<0.01）。
在该成年患者样本中，上气道长度增加与OSA的存在及严重程度相关。
