摘要
目的探讨肥胖患者上气道结构的多层螺旋CT(MSCT)形态学改变,以揭示肥胖患者上气道结构异常及其与阻塞性睡眠呼吸暂停综合征(OSAHS)病情严重程度的关系。方法选择经多导睡眠监测(PSG)确诊的非OSAHS和OSAHS肥胖患者各25例,对所有入组患者进行额窦层面至第7颈椎水平多层螺旋CT扫描及三维重建,测量鼻咽、腭咽、口咽和喉咽的最小截面积及其周围组织并进行比较。并且分析4个平面测量指标与体重指数(BMI)、颈围、睡眠呼吸暂停低通气指数(AHI)等指标的相关性。结果与非OSAHS组患者比较,OSAHS组肥胖患者软腭的面积明显增大(P<0.05),其体积增大更加明显(P<0.01);口咽部气道的截面积、前后径、体积,均比非OSAHS组患者明显减小(P均<0.05),并且软腭的体积均与BMI、AHI呈正相关(P均<0.01)。结论 MSCT能从二维及三维结构评估肥胖患者上气道阻塞及周围软组织情况,并且提示软腭体积增大可能与OSAHS严重程度相关。
Objective To explore the morphological change of upper airway in obese patients with multislice spiral CT （MSCT） scan and post-processing techniques and to reveal the relationship between structural abnormalities and the severity of obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods Adults with obesity were enrolled and divided into OSAHS group （n=25） and non-OSAHS group （n=25） based on polysomnography （PSG）. MSCT covering upper airway was performed and measurements of soft tissue, bone structure and spatial structure of the upper airway were obtained from a 3-dimensional segmentation using image analysis.And their relationship between body mass index（BMI）, neck circumference, apnea hyponea index（AHI） were analyzed. Results Compared with non-OSAHS control group, the area of the soft palate was significantly increased （P〈0.05）. The volume of the soft palate was further significantly increased （P〈0.01）; The cross-sectional area, anteroposterior diameter and volumes of the oropharynx in OSAHS group were decreased （P〈0.05）. The volume of the soft palate had significant positive correlation with BMI and AHI （P〈0.01）. Conclusion MSCT can evaluate obese patients from 2 days and 3 days structure on airway obstruction and surrounding soft tissues, and these results suggest the soft palate volume may be associated with severity of OSAHS.
出处
《医学研究杂志》
2017年第5期94-98,共5页
Journal of Medical Research
基金
浙江省自然科学基金资助项目(Y17H010020)
浙江省温州市科技计划项目(Y20140502)
浙江省苍南县科技计划项目(2014S38)
