Shelton K E, Gay S B, Hollowell D E, Woodson H, Suratt P M
Department of Internal Medicine, University of Virginia Health Science Center, Charlottesville 22908.
Am Rev Respir Dis. 1993 Jul;148(1):195-200. doi: 10.1164/ajrccm/148.1.195.
Although anatomic lesions and obesity can produce obstructive sleep apnea (OSA), most subjects with OSA have no recognizable anatomic lesion. We hypothesized that the occurrence of OSA is related to the size of the region enclosed by the mandible and the degree of obesity. We studied 30 subjects with a range of OSA and obesity with magnetic resonance imaging (MRI). MRI was performed with T-1 weighted sequences. Nocturnal polysomnography was performed in all subjects. Univariate regression analysis indicated there was a significant correlation between the number of apneas and hypopneas per hour of sleep (AH/h) and (1) the area enclosed by the mandible ramus (AMR1) (r = 0.48, p < 0.01) and (2) the distance from the teeth to the posterior mandible ramus (r = 0.39, p < 0.05). Stepwise multiple regression analysis indicated that weight, AMR1, and height explained 69% of the variance of AH/h (r2 = 0.69). We conclude that the occurrence of OSA in these subjects is related to the size of the region enclosed by the mandible as well as to their weight.
虽然解剖学病变和肥胖可导致阻塞性睡眠呼吸暂停(OSA),但大多数OSA患者并无可识别的解剖学病变。我们推测,OSA的发生与下颌骨所围成区域的大小及肥胖程度有关。我们用磁共振成像(MRI)研究了30例患有不同程度OSA和肥胖症的患者。MRI采用T-1加权序列进行。对所有受试者均进行了夜间多导睡眠图监测。单因素回归分析表明,每小时睡眠中的呼吸暂停和低通气次数(AH/h)与(1)下颌支所围成的面积(AMR1)(r = 0.48,p < 0.01)以及(2)牙齿到下颌支后部的距离(r = 0.39,p < 0.05)之间存在显著相关性。逐步多元回归分析表明,体重、AMR1和身高可解释AH/h变异的69%(r2 = 0.69)。我们得出结论,这些患者中OSA的发生与下颌骨所围成区域的大小及其体重有关。