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目的探讨上气道结构特点及顺应性改变在阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)发病中的作用。方法23例40岁以上女性,以呼吸暂停低通气指数(apnea and hypopnea index,AHI)为标准分为3组,比较X线头影测量片各指标的组间差异和不同呼吸状态下CT三维咽腔容积测量各部分容积的变化;观察各指标与OSAHS发病的相关性。结果在X线头影测量片各指标中,AHI<5次/小时组PAS、SNA角、SNB角和上气道最窄距离明显大于AHI>20次/小时组;5次/小时≤AHI≤20次/小时组的上气道最窄距离和SNA角明显大于AHI>20次/小时组。上气道最窄距离和SNA角在以AHI为因变量的回归方程中具有统计学意义,而以最低脉搏血氧饱和度为因变量的方程中,仅有MP-H有统计学意义。咽腔容积测量中,5次/小时≤AHI≤20次/小时组腭咽腔容积变化有统计学意义,AHI>20次/小时组中腭咽腔和舌咽腔容积改变有统计学差异。在以AHI为因变量的回归方程中腭咽腔容积变化率表现出统计学意义。结论上气道解剖结构异常是中老年女性OSAHS发病的形态学基础;上气道顺应性的增高在中老年女性OSAHS发病中起重要作用。
Objective To investigate the role of upper airway structure and compliance in the pathogenesis of obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Twenty-three women aged over 40 years old were divided into three groups according to apnea and hypopnea index (AHI) as standard. Comparisons of inter-group differences and CT three-dimensional pharyngeal cavity under different respiratory conditions Volume measurement of the changes in the volume of each part; Observe the correlation between each index and the incidence of OSAHS. Results In each index of Cephalometric X-ray, PAS, SNA angle, SNB angle and the narrowest distance of upper airway were significantly higher in AHI than 5 times / hour group than in AHI> 20 times / hour group; 5 times / hour≤AHI≤20 The narrowest distance and SNA angle of the upper airway was significantly greater than that of the AHI> 20 beats / hour group. The upper airway narrowest distance and SNA angle were statistically significant in the regression equation with AHI as the dependent variable, whereas only the MP-H was statistically significant in the equation with the lowest pulse oximetry as the dependent variable. In pharyngeal volume measurement, there were significant changes in palatal pharyngeal volume in 5 times / hour≤AHI≤20 times / hour group, while there were significant differences in volume of velopharyngeal cavity and glossopharyngeal cavity in AHI> 20 times / hour group. In the regression equation with AHI as the dependent variable, the rate of change of the velopharyngeal cavity volume showed statistical significance. Conclusion The abnormality of upper airway anatomy is the morphological basis of OSAHS in middle-aged and elderly women. The increased compliance of upper airway plays an important role in the pathogenesis of OSAHS in middle-aged and elderly women.