从阻塞性睡眠呼吸暂停患者的临床数据和打鼾声预测药物诱导睡眠内镜中发现的上气道塌陷部位：一项前瞻性临床研究。
Predicting upper airway collapse sites found in drug-induced sleep endoscopy from clinical data and snoring sounds in patients with obstructive sleep apnea: a prospective clinical study.
机构信息
Department of Orofacial Pain and Dysfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Clinical Neurophysiology, OLVG, Amsterdam, The Netherlands.
出版信息
J Clin Sleep Med. 2022 Sep 1;18(9):2119-2131. doi: 10.5664/jcsm.9998.
STUDY OBJECTIVES
The primary aim was to predict upper airway collapse sites found in drug-induced sleep endoscopy (DISE) from demographic, anthropometric, clinical examination, sleep study, and snoring sound parameters in patients with obstructive sleep apnea (OSA). The secondary aim was to identify the above-mentioned parameters that are associated with complete concentric collapse of the soft palate.
METHODS
All patients with OSA who underwent DISE and simultaneous snoring sound recording were enrolled in this study. Demographic, anthropometric, clinical examination (viz., modified Mallampati classification and Friedman tonsil classification), and sleep study parameters were extracted from the polysomnography and DISE reports. Snoring sound parameters during DISE were calculated.
RESULTS
One hundred and nineteen patients with OSA (79.8% men; age = 48.1 ± 12.4 years) were included. Increased body mass index was found to be associated with higher probability of oropharyngeal collapse ( < .01; odds ratio = 1.29). Patients with a high Friedman tonsil score were less likely to have tongue base collapse ( < .01; odd ratio = 0.12) and epiglottic collapse ( = .01; odds ratio = 0.20) than those with a low score. A longer duration of snoring events ( = .05; odds ratio = 2.99) was associated with a higher probability of complete concentric collapse of the soft palate.
CONCLUSIONS
Within the current patient profile and approach, given that only a limited number of predictors were identified, it does not seem feasible to predict upper airway collapse sites found in DISE from demographic, anthropometric, clinical examination, sleep study, and snoring sound parameters in patients with OSA.
CITATION
Huang Z, Bosschieter PFN, Aarab G, et al. Predicting upper airway collapse sites found in drug-induced sleep endoscopy from clinical data and snoring sounds in obstructive sleep apnea patients: a prospective clinical study. . 2022;18(9):2119-2131.
研究目的
本研究的主要目的是从人口统计学、人体测量学、临床检查、睡眠研究和打鼾声音参数中预测阻塞性睡眠呼吸暂停（OSA）患者药物诱导睡眠内镜（DISE）中发现的上呼吸道塌陷部位。次要目的是确定与软腭完全同心塌陷相关的上述参数。
方法
所有接受 DISE 和同时打鼾声音记录的 OSA 患者均纳入本研究。从多导睡眠图和 DISE 报告中提取人口统计学、人体测量学、临床检查（即改良的马兰帕蒂分类和弗里德曼扁桃体分类）和睡眠研究参数。在 DISE 期间计算打鼾声音参数。
结果
共纳入 119 例 OSA 患者（79.8%为男性；年龄=48.1±12.4 岁）。结果发现，体重指数增加与口咽塌陷的概率更高相关（ <.01；优势比=1.29）。与评分较低的患者相比， Friedman 扁桃体评分较高的患者发生舌基底塌陷的可能性较小（ <.01；比值比=0.12）和会厌塌陷（ <.01；比值比=0.20）。打鼾事件持续时间较长（ <.05；比值比=2.99）与软腭完全同心塌陷的概率更高相关。
结论
在当前患者特征和方法下，鉴于仅确定了有限数量的预测因素，似乎无法从 OSA 患者的人口统计学、人体测量学、临床检查、睡眠研究和打鼾声音参数中预测 DISE 中发现的上呼吸道塌陷部位。
引文
Huang Z, Bosschieter PFN, Aarab G, et al. Predicting upper airway collapse sites found in drug-induced sleep endoscopy from clinical data and snoring sounds in obstructive sleep apnea patients: a prospective clinical study.. 2022;18(9):2119-2131.
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