中重度OSAHS患者舌体MRI与上气道测压舌后区阻塞的相关性分析

熊国锋; 胡建文; 陈伟军; 曾一民; 郑文龙

doi:10.13201/j.issn.1001-1781.2015.21.003

中重度OSAHS患者舌体MRI与上气道测压舌后区阻塞的相关性分析

- 1. 温州市中心医院耳鼻咽喉头颈外科(浙江温州, 325000);
- 2. 温州市中心医院医学影像科
基金项目:
温州市科技局(No:Y20130119)

浙江省医药卫生一般研究计划(No:2012KYA174)

详细信息

通讯作者: 陈伟军,E-mail:chenwj408@163.com

中图分类号: R563.8

收稿日期: 2015-08-13

The analysis of correlation between tongue body MRI and upper airway pressure measurements of blocked lingual region in patients with moderate and severe OSAHS

- 1 Department of Otolaryngology-Head and Neck Surgery, the Central Hospital of Wenzhou, Wenzhou, 325000, China;
- 2 Department of Image, the Central Hospital of Wenzhou

More Information

Corresponding author: CHEN Weijun, E-mail: chenwj408@163.com

Received Date: 13 August 2015

摘要

摘要: 目的: 探讨OSAHS患者舌体MRI测量值与舌后区阻塞的相关性,判断二者在阻塞平面定位诊断中的关系,以提高术前对OSAHS患者阻塞平面诊断的准确性。方法: 对经AG200睡眠呼吸监测及阻塞平面定位系统确诊的符合纳入标准的59例OSAHS患者行舌体MRI检查并进行三维重建,利用计算机系统测出舌体长径、相对厚度,基底部左右宽径、中部左右宽径及舌体体积。将AG200确定的下部阻塞(主要为舌后区)构成比P与舌体MRI检查所测得各测量参数做相关性分析,同时分析不同程度OSAHS患者下部阻塞构成比之间的差异。结果: 59例患者舌体长径、相对厚度、基底部左右宽径、中部左右宽径及舌体体积与下部阻塞构成比P之间的相关系数分别为r_LP=0.051,r_HP=0.069,r₁=0.215,r₂=0.147,r_VP=0.259,不同程度OSAHS患者下部阻塞构成比之间均差异有统计学意义(P<0.05)。可见舌体各测量参数均与下部阻塞构成比P呈负相关,说明在排除了喉部及喉咽部狭窄的前提下,经AG200测得的下平面狭窄与舌体MRI测得的各参数均有关系,与舌体体积相关性最强。结论: 舌体体积与AG对下部阻塞的判定有明显相关性趋势,OSAHS患者下部阻塞构成比之间随病情严重程度而变化,两者结合可作为预测OSAHS患者睡眠时上气道阻塞平面的参考,可为OSAHS治疗的个体化提供依据。
- 睡眠呼吸暂停低通气综合征 /
- 阻塞性 /
- 舌体 /
- MRI
Abstract: Objective: To investigate the correlation between tongue body MRI measurements and the lingual region obstruction in patients with obstructive sleep apnea hypopnea syndrome (obstructive sleep apnea hypopnea syndrome, OSAHS), and the relationship of two diagnosis methods in positioning obstructive level, in order to improve the preoperative diagnostic accuracy of obstructive level in OSAHS patients.Method: Fifty-nine patients with OSAHS definited by the AG200 sleep apnea monitoring and obstruction plane positioning system was included. They all underwent tongue MRI scan, after three-dimensional reconstruction, the tongue body length to diameter, relative thickness, basal diameter, wide around central about wide diameter and tongue body volume were measured. The lower blocking (mainly composed of lingual region) constituent ratio P established by AG200 was correlated with tongue parameters measured by MRI. At the same time, To analysis of differences of P in patients with different degree of OSAHS.Result: Among these patients with OSAHS in different degree, the coefficient correlation between tongue parameters(tongue length, relative thickness, basal diameter, wide middle diameter,tongue body volume) and lower blocking constitute ratio P werer_LP=0.051,r_HP=0.069, r₁=0.215, r₂=0.147, r_VP=0.259, respectively. lower obstruction of form than the differences had statistical significance. The measured tongue parameters and value P(the lower blocking constituent ratio) were negatively correlated, which demonstrated that exclusing of the larynx and hypopharynx airway obstruction, the lower airway obstruction detected by AG200 was related with tongue parameters measured by MRI, and was strongestly related with the tongue body volume.Conclusion: The volume of tongue and AG had correlation in judgement of lower blocking.In OSAHS patients the lower blocking constituent ratio varies between the defferent severity groups of the disease, the combination of the two method can be used to predict the obstructive plane in OSAHS patients with upper airway obstruction, and provide the basis for the individual treatment of patients with OSAHS.
- sleep apnea hypopnea syndrome /
- obstructive /
- tongue /
- MRI

HTML全文

参考文献(10)

[1]	中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉头颈外科学分会咽喉学组.阻塞性睡眠呼吸暂停低通气综合征诊断和外科治疗指南[J].中华耳鼻咽喉头颈外科杂志,2009,44(2):95-96.
[2]	TVINNEMIM M,MITIC S,HANSEN R K.Plasma radiofrequency preceded by pressure recording enhances success for treating sleep-related breathing disorders[J].Laryngoscope,2007,117:73l-736.
[3]	PAEE K, WU J, NGUYEN D, et al. Geniohyoid muscle properties and myosin heavy chain composition are altered after short-term intermittent hypoxic exposure[J]. J Appl Physiol, 2005, 98:889-894.
[4]	CROFT C B, WOOD D G. Use and complication of uvultopal atopharyngoplastay[J]. J Laryngolotol, 1990,104:871-875.
[5]	袁英,潘新良,李学忠,等.重度阻塞性睡眠呼吸暂停低通气综合征的多平面外科治疗[J].临床耳鼻咽喉科杂志,2006, 20(11):502-504.
[6]	李五一,神平,杨大海,等.ApneaGraph在睡眠呼吸疾病诊断和上气道阻塞定位中的初步应用[C].乌鲁木齐:2006年全国阻塞性睡眠呼吸暂停低通气综合征专题学术会议论文集,2006:26-28.
[7]	李树华,石洪金,吴大海,等.舌腭关系分型对阻塞性睡眠呼吸暂停低通气综合征患者舌后区呼吸道狭窄的预测意义[J].中华耳鼻咽喉头颈外科杂志,2007,42(12):910-914.
[8]	FRIEDMAN M,IBRAHIM H,JOSEHN N J.Staging of obstructive sleep appea/hypopnea syndrome:a guide to appropriate treatmennt[J]. Laryngoscop,2004,114:454-459.
[9]	李彦如,韩德民,叶京英,等.阻塞性睡眠呼吸暂停患者咽腔阻塞的整夜定位及影响因素分析[J].中华耳鼻咽喉头颈外科杂志,2006,41(6):437-442.
[10]	神平,李五一,田旭,等.上气道测压阻塞定位在阻塞性睡眠呼吸暂停低通气综合征外科治疗中的应用[J].中华耳鼻咽喉头颈外科杂志,2010,45(1):45-47.