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目的:探讨不同头部X线测量方法与儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)严重程度的关系,进一步评价头部X线测量在儿童OSAHS诊断筛查中的应用价值。方法:对61名患儿行PSG及包括颈段气管的鼻咽侧位X线摄片检查。在鼻咽侧位片上测量腺样体的厚度、直接测量法测量腺样体-鼻咽腔比率、邹明舜法测量腺样体-鼻咽腔比率、最窄上咽气道间隙(PAS)、最窄上咽气道间隙-气管直径比值(PAS/TD),并分析它们与PSG值的相关性及预测儿童OSAHS严重程度的意义。结果:头部X线测量各指标均与AHI、AI有相关性(均P<0.01)。Stepwise逐步回归法分析,入选回归方程的变量只有PAS/TD。用受试者工作特征曲线(ROC曲线)进行分析,PAS/TD用于判断儿童OSAHS的严重程度有统计学意义(P<0.01)。判断儿童轻度与中重度OSAHS的最佳临界值为0.658,此时敏感度为81.8%,特异度为76.5%。头部X线测量各指标与最低血氧饱和度(LSaO2)无相关性(P>0.01)。结论:PAS/TD是临床上进行儿童中重度OSAHS筛查的有用指标,但不能预测患儿LSaO2的严重程度。
Objective: To explore the relationship between different head X-ray measurement methods and the severity of obstructive sleep apnea-hypopnea syndrome (OSAHS) in children, and to evaluate the value of head X-ray in screening and diagnosis of OSAHS in children. Methods: Sixty-one children underwent nasopharyngeal lateral X-ray examination of PSG and including the trachea of the neck. Adenosomal thickness was measured on the nasopharyngeal lateral radiographs. Adeno-nasopharyngeal ratio was measured by direct measurement. The Adeno-nasopharyngeal ratio, the narrowest upper pharyngeal airway space (PAS), the narrowest On the pharyngeal airway clearance - tracheal diameter ratio (PAS / TD), and analyze their correlation with the PSG value and predict the severity of OSAHS in children. Results: The indexes of head X-ray were correlated with AHI and AI (all P <0.01). Stepwise regression analysis, the variables included in the regression equation only PAS / TD. The receiver operating characteristic curve (ROC curve) analysis, PAS / TD used to determine the severity of OSAHS in children was statistically significant (P <0.01). The best cut-off value for judging children with mild and moderate OSAHS was 0.658, the sensitivity was 81.8% and the specificity was 76.5%. Head X-ray measurements of each index and the lowest oxygen saturation (LSaO2) no correlation (P> 0.01). Conclusion: PAS / TD is a useful clinical indicator for screening moderate and severe OSAHS in children, but it can not predict the severity of LSaO2 in children.