摘要
目的定量检测咽容积和鼻腔最小截面积在阻塞性睡眠呼吸暂停(OSA)早期筛查中的应用价值。方法选择2017年5月~2021年5月入我院经多导睡眠监测(PSG)确诊OSA患者共112例,呼吸暂停低通气指数(AHI)≥5,另45例AHI<5作为对照组。比较两组性别、年龄、身高、体重和体质指数(BMI)、Epworth嗜睡量表(ESS)评分,PSG参数[AHI、最低动脉血氧饱和度(LSaO2)、血氧饱和度低于90%的时间百分比(SIT90)],声反射咽测量技术检测咽容积,声反射鼻测量技术检测坐位、仰卧位和侧位的鼻腔最小截面积(mCSA),以及扁桃体增大和舌肥大程度。结果OSA组患者体重、BMI值、ESS评分、AHI值、SIT90、以及扁桃体增大和舌肥大程度均明显大于对照组,而LSaO2、咽容积、坐位、仰卧位和侧位mCSA显著低于对照组,差异有统计学意义(P<0.05)。Spearman检验显示,咽容积与AHI值和SIT90呈负相关,与LSaO2呈正相关;仰卧位mCSA与AHI值和SIT90呈负相关,与LSaO2呈正相关;侧位mCSA与AHI值呈负相关(P<0.05)。受试者工作曲线(ROC)显示,咽容积、mCSA以及联合诊断OSA的曲线下面积(AUC)分别为0.801、0.756和0.879(P<0.05)。结论声反射咽测量和鼻测量作为一种无创技术定量检测咽容积和多体位mCSA值与PSG测量AHI值有较好的相关性,联合咽容积和mCSA值作为早期筛查OSA的重要指标有较好的应用价值。
Objective To evaluate the application value of pharyngeal volume combined with minimal nasal cross-sectional area in early screening of obstructive sleep apnea(OSA).Methods A total of 112 patients with OSA diagnosis by polysomnography(PSG)from May 2017 to May 2021 were chosed with apnea-hypopnea index(AHI)≥5,other 45 patients with AHI<5 were in the control group.Gender,age,height,weight,body mass index(BMI),Epworth Sleepiness Scale(ESS)score,PSG parameters[AHI,minimum arterial oxygen saturation(LSaO2),percentage of time during blood oxygen saturation less than 90%(SIT90)],pharyngeal volume detected by acoustic pharyngometry,minimum nasal cross-sectional area(mCSA)in sitting,supine and lateral positions detected by acoustic rhinometry,degree of tonsil enlargement and tongue hypertrophy were compared between the two groups.Results The values of weight,BMI,ESS score,AHI,SIT90,tonsil enlargement and tongue hypertrophy degrees in OSA group were significantly higher than those in control group,while LSaO2,pharyngeal volume,mCSA in sitting,supine and lateral positions were significantly lower than those in control group,too(P<0.05).Spearman test showed that pharyngeal volume was negatively correlated with AHI and SIT90,and positively correlated with LSaO2;mCSA in supine position was negatively correlated with AHI and SIT90,and positively correlated with LSaO2;lateral mCSA was negatively correlated with AHI(P<0.05).Receiver operating curve(ROC)showed that the area under the curve(AUC)of pharyngeal volume,mCSA and combined diagnosis for OSA were 0.801,0.756 and 0.879,respectively(P<0.05).Conclusion As a non-invasive technique,acoustic pharyngometry and rhinometry can quantitatively detect pharyngeal volume and multi positions mCSA,which are good correlation between PSG measurement of AHI.Combination of pharyngeal volume and mCSA as an important index for early screening of OSA has a good application value.
作者
杨彬
缪世军
张衡
YANG Bin;MIAO Shijunm ZHANG Heng(Department of Otorhinolaryngology,Suzhou Kowloon Hospital,Shanghai Jiaotong University School of Medicine,Suzhou,Jiangsu,215000,China)
出处
《中国中西医结合耳鼻咽喉科杂志》
2023年第5期344-348,共5页
Chinese Journal of Otorhinolaryngology in Integrative Medicine
基金
2020年江苏省重点研发计划(社会发展)专项资金项目(BE2020786)。
