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目的 :通过对阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者的颞下颌关节(temporomandibular joint,TMJ)行磁共振扫描分析,探讨OSAHS患者与正常人群颞下颌关节形态的差异。方法:选取2014年1月—2016年5月收治的18例OSAHS患者和18例健康成人,分别记为研究组和对照组;按照呼吸暂停及低通气指数(apnea and hypopnea index,AHI),将OSAHS患者分为轻、中、重3个亚组(n=6)。对所有纳入人群行TMJ的MRI扫描并测量关节间隙,采用SPSS 17.0软件包对测量数据进行统计学处理。结果:2组患者在年龄、性别构成、关节上间隙及髁突有无移位方面差异均无显著性(P>0.05)。OSAHS患者TMJ左侧前间隙[(2.61±0.19)mm∶(2.47±0.18)mm,P<0.05]、右侧前间隙[(2.63±0.18)mm∶(2.48±0.17)mm,P<0.05]大于正常人群。OSAHS患者TMJ左侧后间隙[(2.43±0.20)mm∶(2.51±0.19)mm,P<0.05]、右侧后间隙[(2.44±0.20)mm∶(2.60±0.13)mm,P<0.05]小于正常人群。轻度OSAHS组TMJ左侧前间隙[(2.53±0.26)mm∶(2.73±0.07)mm,P<0.05]、右侧前间隙[(2.54±0.11)mm∶(2.74±0.14)mm,P<0.05]均小于重度组;轻度OSAHS组TMJ左侧后间隙[(2.56±0.29)mm∶(2.29±0.09)mm,P<0.05]、右侧后间隙[(2.55±0.23)mm∶(2.31±0.09)mm,P<0.05]均大于重度组。结论 :OSAHS患者的髁突相比正常人群处于关节窝偏后位置。髁突位于关节窝偏后位置的趋势与OSAHS的严重程度相关。
OBJECTIVE: To investigate the relationship between temporomandibular joint (TMJ) and OSAHS in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) by magnetic resonance scanning difference. Methods: Eighteen patients with OSAHS and 18 healthy adults admitted from January 2014 to May 2016 were selected as the study group and the control group. According to the apnea and hypopnea index (AHI) OSAHS patients were divided into mild, moderate and severe subgroups (n = 6). MRI scans of all TMJ included in the population and measurement of joint space were performed using the SPSS 17.0 software package for statistical analysis of the measurement data. Results: There was no significant difference in age, gender, joint space and condylar displacement between the two groups (P> 0.05). (2.61 ± 0.19) mm: (2.47 ± 0.18) mm, P <0.05], and the right anterior gap [(2.63 ± 0.18) mm: (2.48 ± 0.17) mm, P <0.05] Greater than the normal population. (2.43 ± 0.20) mm: (2.51 ± 0.19) mm, P <0.05], and the right posterior clearance was (2.44 ± 0.20) mm: (2.60 ± 0.13) mm in OSJI patients, Less than normal population. In the mild OSAHS group, the left anterior gap ([2.53 ± 0.26] mm: (2.73 ± 0.07) mm, P <0.05] and the right anterior gap (2.54 ± 0.11) mm: (2.56 ± 0.29) mm: (2.29 ± 0.09) mm, P <0.05], while the right posterior clearance [(2.55 ± 0.23) mm: (2.31 ± 0.23) mm] was significantly lower than that of the mild OSAHS group ± 0.09) mm, P <0.05] were greater than the severe group. CONCLUSIONS: The condyles of patients with OSAHS are in the posterior fossa position compared to the normal population. The tendency of the condyle to be located posterior to the joint fossa is related to the severity of OSAHS.