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目的:了解阻塞性睡眠呼吸暂停综合征(OSAS)病人与正常人的上气道形态结构特征;评价上气道CT检查对OSAS的诊断价值和临床应用前景。方法:随机选取120例观察对象,根据临床表现和多导睡眠呼吸(PSG)监测结果分为正常组、轻度OSAS组、中度OSAS组和重度OSAS组。对120例受试者行上气道CT扫描,分别测出鼻咽腔、口咽腔和喉咽腔截面积的大小,比较OSAS病人和正常人间上气道截面积的差别,以及轻、中、重度OSAS病人间上气道截面积的差别。结果:正常人和OSAS病人清醒状态上气道不同截面比较,最狭窄部位均在口咽部(P<0.05)。OSAS病人鼻咽腔、口咽腔和喉咽腔截面积均比正常人小(P<0.05)。轻、中、重度OSAS病人口咽腔截面积大小差别有统计学意义(P<0.05),鼻咽腔大小差别无统计学意义(P>0.05)。重度OSAS病人喉咽腔大小比轻、中度OSAS病人小(P<0.05)。轻、中度OSAS病人的喉咽腔大小差异无统计学意义。结论:上气道CT检查对OSAS有较高的诊断和鉴别诊断价值,可以观察到OSAS病人上气道狭窄的部位、程度、范围,并有助于治疗方案的选择。
OBJECTIVE: To understand the morphological features of upper airways in patients with obstructive sleep apnea syndrome (OSAS) and normal subjects and to evaluate the diagnostic value and clinical application of upper airway CT in the diagnosis of OSAS. Methods: One hundred and twenty subjects were randomly selected and divided into normal group, mild OSAS group, moderate OSAS group and severe OSAS group according to the clinical manifestations and the results of polysomnography (PSG). The airway CT scan of 120 subjects was performed. The size of the nasopharyngeal cavity, oropharyngeal cavity and hypopharyngeal cavity were measured respectively. The differences of upper airway cross-sectional area between OSAS patients and normal controls were compared, , Severe OSAS patients the difference between the upper airway cross-sectional area. Results: The stenosis of the normal and OSAS patients in the awake state were all in the oropharynx (P <0.05). OSAS patients nasopharyngeal, oropharyngeal and hypopharyngeal cavity cross-sectional area than normal (P <0.05). The size of oropharyngeal cavity in mild, moderate and severe OSAS patients was significantly different (P <0.05), while there was no significant difference in nasopharyngeal size (P> 0.05). The size of hypopharyngeal cavity in patients with severe OSAS was smaller than that in mild and moderate OSAS patients (P <0.05). There was no significant difference in the size of hypopharyngeal cavity between mild and moderate OSAS patients. Conclusion: Upper airway CT examination has high diagnostic and differential diagnostic value on OSAS. The location, extent and range of upper airway stenosis in OSAS patients can be observed and the choice of treatment options is helpful.