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重度阻塞性睡眠呼吸暂停患者上气道的变化:使用三维多层螺旋CT对上气道长度及容积的分析

Upper airway changes in severe obstructive sleep apnea: upper airway length and volumetric analyses using 3D MDCT.

作者信息

Kim Eun Joong, Choi Ji Ho, Kim Yeon Soo, Kim Tae Hoon, Lee Sang Hag, Lee Heung Man, Shin Chol, Lee Seung Hoon

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, 516 Gojan-dong, Danwon-gu, Ansan-si, Gyeonggi-do, Korea.

出版信息

Acta Otolaryngol. 2011 May;131(5):527-32. doi: 10.3109/00016489.2010.535561. Epub 2010 Dec 20.

Abstract

CONCLUSION

Three-dimensional multi-detector computed tomography (3D MDCT) analysis of the upper airway suggested that the lengthening of the upper airway in the absence of volumetric change may independently contribute to the severity of obstructive sleep apnea syndrome (OSAS) in adults.

OBJECTIVES

We sought to investigate the relationships among the length and volume of the upper airway to the severity of OSAS.

METHODS

A total of 73 subjects underwent 3D MDCT scanning and standard polysomnography. We measured the upper airway length (UAL), which was defined as the vertical distance from the hard palate to the hyoid in the mid-sagittal plane. We also used the height-adjusted UAL for analyses. Upper airway volume was measured using a 3D reconstruction of the cross-sectional area from the hard palate to the hyoid.

RESULTS

The adjusted UAL showed a significant positive correlation with the apnea hypopnea index (AHI, r = 0.523, p < 0.000) and was a significant variable for predicting the AHI of OSAS patients in multiple stepwise regression analysis. Although the severe OSAS group had a greater adjusted UAL compared with that of other groups (p = 0.001), the volume of the upper airway did not show differences among groups.

摘要

结论

对上气道进行三维多排螺旋计算机断层扫描(3D MDCT)分析表明,在无容积变化的情况下上气道延长可能独立导致成人阻塞性睡眠呼吸暂停综合征(OSAS)的严重程度增加。

目的

我们试图研究上气道的长度和容积与OSAS严重程度之间的关系。

方法

共有73名受试者接受了3D MDCT扫描和标准多导睡眠图检查。我们测量了上气道长度(UAL),其定义为在正中矢状面从硬腭到舌骨的垂直距离。我们还使用了高度校正的UAL进行分析。上气道容积通过对从硬腭到舌骨的横截面积进行三维重建来测量。

结果

校正后的UAL与呼吸暂停低通气指数(AHI,r = 0.523,p < 0.000)呈显著正相关,并且在多元逐步回归分析中是预测OSAS患者AHI的显著变量。尽管重度OSAS组的校正后UAL比其他组更大(p = 0.001),但上气道容积在各组之间未显示出差异。

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