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目的:了解阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者口咽部不同平面咽壁顺应性。方法:对确诊OSAHS患者24例和健康对照组10例,应用螺旋CT(MSCT)在平静呼吸和Muller法检查的2种状态下对上呼吸道进行连续扫描,测量软腭游离缘平面、舌后区平面和会厌游离缘平面的咽腔横截面积和咽后壁软组织厚度,根据2种状态下咽腔截面积计算咽壁顺应性。结果:OSAHS组咽壁顺应性较对照组大,OSAHS组在软腭平面和舌后区平面咽壁顺应性与对照组比较差异有统计学意义;OSAHS组咽后壁软组织厚度在软腭游离缘平面、舌后区平面和会厌游离缘平面分别为(7.5±2.2)mm、(4.8±1.3)mm、(2.3±0.2)mm,与对照组比较,软腭游离缘平面明显增厚(P<0.01);咽后壁软组织厚度与咽壁顺应性Pearson相关性分析,2组在咽壁从上至下3个平面上的相关系数依次减小,但只有OSAHS组在软腭游离缘平面的相关系数有统计学意义(P<0.05)。结论:利用MSCT扫描测量可以实现口咽部各平面咽壁顺应性的定量评估,为临床提供客观定量的指标;OSAHS患者口咽部咽壁顺应性在软腭平面最大,咽后壁软组织厚度与咽壁顺应性有一定的相关性,并且在软腭平面表现最为密切。
Objective: To understand the compliance of different pharyngeal pharyngeal pharyngeal wall in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods: Twenty-four patients diagnosed with OSAHS and 10 healthy controls were enrolled in this study. The upper respiratory tract was scanned continuously by spiral CT (MSCT) in two states of mimic breath test and Muller test. The free margin of the soft palate, And epiglottis swim edge of the pharynx cross-sectional area and pharyngeal soft tissue thickness, pharyngeal wall area under the two conditions calculated pharyngeal wall compliance. Results: The compliance of the pharyngeal wall in OSAHS group was larger than that in control group. The OSAHS group showed significant difference in compliance between phalangeal plane and lingual posterior pharyngeal wall compared with control group. The thickness of soft tissue in pharyngeal wall of OSAHS group was higher than that in OSAHS group, (7.5 ± 2.2) mm, (4.8 ± 1.3) mm and (2.3 ± 0.2) mm respectively in the posterior lingual area and the epiglottis. Compared with the control group, the free edge of the soft palate was significantly thicker (P <0.01). Correlation analysis between soft tissue thickness of pharyngeal wall and compliance of pharyngeal wall showed that the correlation coefficients of three groups in the pharyngeal wall decreased from the top to the bottom, but only the OSAHS group had statistically significant correlations Significance (P <0.05). Conclusion: Quantitative assessment of compliance of pharyngeal wall of pharynx with or without CT scan can be quantitatively evaluated by MSCT scan, providing an objective and quantitative index for clinical diagnosis. The compliance of pharyngeal wall in oropharynx of OSAHS is the largest in soft palate plane, Wall compliance has a certain correlation, and most closely in the soft palate plane.