Department of Traumatology, National Taiwan University Hospital, Taipei City, Taiwan.
PLoS One. 2013 May 10;8(5):e62848. doi: 10.1371/journal.pone.0062848. Print 2013.
This study aimed to explore the association between obstructive sleep apnea (OSA) severity and pharyngeal parameters using sub-mental ultrasonography (US), and investigate the accuracy of US for identifying severe OSA patients.
One hundred and five consecutive referrals for suspected OSA were enrolled. The diameters of the retro-glossal (RG) and retro-palatal (RP) regions were measured via sub-mental US upon expiration during tidal breathing, forced inspiration, and Müller maneuver (MM). Independent factors associated with severe OSA identified from two-thirds of randomly-selected patients (model-development group) were used to construct a model for predicting severe OSA. The accuracy of the model was validated in the remaining one-third of patients (validation group).
Fifty severe OSA patients, 30 with mild-moderate OSA, and 25 without OSA were enrolled. Compared to non-OSA and mild-moderate OSA patients, those with severe OSA had narrower RP diameter in all three maneuvers. Using the prediction model constructed with changes of RP diameters at MM and neck circumference, the independent predictors of severe OSA in the model-development group had 100% sensitivity and 65% specificity.
Sub-mental US can accurately discriminate the severity of OSA and be used to identify patients with severe OSA.
ClinicalTrials.gov NCT00674076.
本研究旨在通过颏下超声（US）探讨阻塞性睡眠呼吸暂停（OSA）严重程度与咽腔参数的关系，并探讨 US 识别重度 OSA 患者的准确性。
共纳入 105 例疑似 OSA 的连续转介患者。在静息状态下经颏下 US 测量呼吸末时的舌后（RG）和腭后（RP）区域的直径，同时测量在平静呼吸、用力吸气和 Müller 动作（MM）时的直径。从三分之二随机选择的患者（模型建立组）中确定与重度 OSA 相关的独立因素，用于构建预测重度 OSA 的模型。在剩余的三分之一患者（验证组）中验证模型的准确性。
共纳入 50 例重度 OSA 患者、30 例轻中度 OSA 患者和 25 例无 OSA 患者。与非 OSA 和轻中度 OSA 患者相比，重度 OSA 患者在所有三种动作时的 RP 直径均较窄。使用 MM 时 RP 直径变化和颈围构建的预测模型，模型建立组中重度 OSA 的独立预测因子具有 100%的敏感性和 65%的特异性。
颏下 US 可准确区分 OSA 的严重程度，并用于识别重度 OSA 患者。
ClinicalTrials.gov NCT00674076。
