Avrahami E, Solomonovich A, Englender M
Department of Radiology, Edith Wolfson Medical Center, Holon, Israel.
AJNR Am J Neuroradiol. 1996 Jun-Jul;17(6):1107-11.
To determine whether narrowing of the oropharynx increases during relaxation in patients with severe obstructive sleep apnea syndrome.
The study included 23 adult men in whom polysomnography had established a diagnosis of obstructive sleep apnea syndrome. Subjects had an average of 53 episodes of sleep apnea per hour, with each episode lasting 40 seconds or more. Oxygen saturation dropped an average of 22% during sleep. Hypnotic relaxation was induced in all patients, and high-resolution CT scans with sagittal and coronal reconstruction of the oropharynx were obtained in the awake state and during the relaxation state using the same parameters. The cross-sectional area of the oropharynx was measured in a minimum of 10 CT axial sections in each case.
In all patients, the narrowest cross-sectional area of the oropharynx was smaller during hypnotic relaxation than in the awake state. The average difference between both measures was 42%. In the awake state, the measurements ranged from 15 to 55 mm2 (average, 38 mm2). During hypnotic relaxation, they ranged from 0 to 35 mm2. Oxygen saturation during hypnotic relaxation dropped in all patients from 9% to 17% (average, 14%). No episodes of sleep apnea were observed during hypnotic relaxation.
In patients with obstructive sleep apnea, airways were demonstrably smaller in diameter during hypnotic relaxation than during the awake state.
确定重度阻塞性睡眠呼吸暂停综合征患者在放松过程中口咽腔狭窄是否会加重。
该研究纳入了23名成年男性，经多导睡眠监测确诊为阻塞性睡眠呼吸暂停综合征。受试者平均每小时有53次睡眠呼吸暂停发作，每次发作持续40秒或更长时间。睡眠期间血氧饱和度平均下降22%。对所有患者进行催眠放松诱导，并在清醒状态和放松状态下使用相同参数获取口咽腔矢状面和冠状面重建的高分辨率CT扫描图像。每种情况下，至少在10个CT轴位层面测量口咽腔的横截面积。
在所有患者中，催眠放松期间口咽腔最窄横截面积均小于清醒状态。两种测量结果的平均差异为42%。清醒状态下，测量值范围为15至55平方毫米（平均38平方毫米）。催眠放松期间，测量值范围为0至35平方毫米。所有患者在催眠放松期间血氧饱和度下降了9%至17%（平均14%）。催眠放松期间未观察到睡眠呼吸暂停发作。
在阻塞性睡眠呼吸暂停患者中，催眠放松期间气道直径明显小于清醒状态。
