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[非结构性因素所致阻塞性睡眠呼吸暂停低通气综合征患者咽壁松弛的研究]

[Study on pharyngeal wall floppiness of patients with obstructive sleep apnea-hypopnea syndrome attributable to non-structural factors].

作者信息

Lin Z Q, Jiang K L, Zhao L, Li S N, Shao S, Qian W, Tao Z Z

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Wuhan University Renmin Hospital, Wuhan 430060, China.

Department of Otorhinolaryngology Head and Neck Surgery, Jiangsu University Affiliated People's Hospital, Zhenjiang 212002, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Sep 7;52(9):676-680. doi: 10.3760/cma.j.issn.1673-0860.2017.09.008.

Abstract

Acoustic pharyngealmetry technology is utilized to evaluate the change and clinical significance of obstructive sleep apnea-hypopnea syndrome (OSAHS) patients caused by non-upper airway structural factor and normal individuals' PWF(pharyngeal wall floppiness). Acoustic pharyngealmetry instrument of Ecconvision was utilized to examine 102 OSAHS patients and 50 normal individuals, separately recorded their volume of pharyngeal cavity in sit or supine position, calculated PWF in sit or supine position, and SPSS 12.0 of tware was used to analyze data. PWF was 0.14±0.09 in sit position and PWF was 0.21±0.10, (=5.96, =9.63, <0.001)in supine position of OSAHS group, which were all significantly higher than those of control group. PWFs in supine position of OSAHS group and control group were evidently higher than PWF(=-11.91, <0.001; =-2.32, =0.025) in sit position. ΔPWF(PWF_supine-PWF_sit)was 0.063±0.054 in OSAHS group which was significantly greater than in control(=41.173, <0.01). PWF in sit position and supine position were all positively related with age(=0.714, =0.735, <0.001)while irrelevant with BMI(>0.05). PWF can be utilized to be an index to reflect the physiological feature of upper airway. PWF can more precisely reflect upper airway collapsibility of OSAHS patients on the condition of PWF in supine position. Pharyngeal wall floppiness quantified as a high PWF index is a non-structure vital factor of OSAHS patients and plays a role of guiding us to make personal treatment plans for OSAHS patients.

摘要

应用声学咽测技术评估非上气道结构因素所致阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者及正常个体咽壁松弛度(PWF)的变化及临床意义。采用丹麦Madsen公司的Ecconvision声学咽测仪分别检测102例OSAHS患者和50例正常个体,分别记录其坐位及仰卧位时的咽腔容积,计算坐位及仰卧位时的PWF,并应用SPSS 12.0软件进行统计学分析。OSAHS组坐位时PWF为0.14±0.09,仰卧位时PWF为0.21±0.10(t=5.96,P=9.63,P<0.001),均显著高于对照组。OSAHS组和对照组仰卧位时的PWF均明显高于坐位时(t=-11.91,P<0.001;t=-2.32,P=0.025)。OSAHS组ΔPWF(PWF仰卧位-PWF坐位)为0.063±0.054,显著大于对照组(t=41.173,P<0.01)。坐位及仰卧位时PWF均与年龄呈正相关(r=0.714,P=0.735,P<0.001),而与BMI无关(P>0.05)。PWF可作为反映上气道生理特征的指标。在仰卧位PWF条件下,PWF能更准确地反映OSAHS患者的上气道可塌陷性。以高PWF指数量化的咽壁松弛度是OSAHS患者的非结构重要因素,对指导制定OSAHS患者个体化治疗方案有重要意义。

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