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阻塞性睡眠呼吸暂停患者上气道形态学变化:年龄对咽部解剖结构的影响。

Upper airway morphological changes in obstructive sleep apnoea: effect of age on pharyngeal anatomy.

作者信息

Gao F, Li Y R, Xu W, An Y S, Wang H J, Xian J F, Han D M

机构信息

Department of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, China.

Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, China.

出版信息

J Laryngol Otol. 2020 Apr;134(4):354-361. doi: 10.1017/S0022215120000766. Epub 2020 Apr 14.

Abstract

OBJECTIVE

To evaluate the upper airway morphology changes associated with ageing in adult Chinese patients with obstructive sleep apnoea.

METHODS

A total of 124 male patients diagnosed with obstructive sleep apnoea by overnight polysomnography, who underwent upper airway computed tomography, were enrolled. The linear dimensions, cross-sectional area and volume of the upper airway region and the surrounding bony frame were measured. The association between ageing and upper airway morphology was analysed.

RESULTS

Soft palate length, minimum cross-sectional area of the retroglossal region, lateral dimensions at the minimum cross-sectional area of the retropalatal and retroglossal regions, nasopharyngeal volume, and average cross-sectional area of the nasopharyngeal region were found to significantly increase with ageing in all patients, while the upper airway shape flattened with ageing. The volume of the retropalatal region increased with ageing among the patients with a body mass index of less than 24 kg/m2. The volume of parapharyngeal fat pad increased with ageing among patients with a body mass index greater than 28 kg/m2.

CONCLUSION

A number of dimensional, cross-sectional and volumetric parameters of the pharynx increased with age, indicating that non-anatomical factors may play a more important role in the pathogenesis of obstructive sleep apnoea in aged patients.

摘要

目的

评估成年中国阻塞性睡眠呼吸暂停患者上气道形态随年龄增长的变化。

方法

纳入124例经夜间多导睡眠图诊断为阻塞性睡眠呼吸暂停且接受过上气道计算机断层扫描的男性患者。测量上气道区域及其周围骨框架的线性尺寸、横截面积和体积。分析年龄与上气道形态之间的关联。

结果

发现所有患者的软腭长度、舌后区域最小横截面积、腭后和舌后区域最小横截面积处的横向尺寸、鼻咽体积以及鼻咽区域平均横截面积均随年龄增长而显著增加,而上气道形状随年龄增长变扁平。在体重指数小于24kg/m²的患者中,腭后区域体积随年龄增长而增加。在体重指数大于28kg/m²的患者中,咽旁脂肪垫体积随年龄增长而增加。

结论

咽部的一些尺寸、横截面积和体积参数随年龄增长而增加,表明非解剖学因素可能在老年患者阻塞性睡眠呼吸暂停的发病机制中起更重要作用。

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