OSAHS患者清醒和睡眠状态下阻塞平面的VOTE评分比较

黄晓星; 陈怀宏; 唐靖; 鲁娟; 邓月琴; 李湘平

doi:10.13201/j.issn.1001-1781.2017.12.006

OSAHS患者清醒和睡眠状态下阻塞平面的VOTE评分比较

- 南方医科大学南方医院耳鼻咽喉科(广州, 510515)
基金项目:
广东省自然科学基金博士启动项目 (No:2015A030310049)

详细信息

通讯作者: 李湘平,E-mail:li321162@qq.com

中图分类号: R563.8

收稿日期: 2017-03-08

Comparative study of VOTE classification in obstructive sleep apnea hypopnea syndrome patients between awake and sleep state

- Department of Otorhinolaryngology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China

More Information

Corresponding author: LI Xiangping, E-mail: li321162@qq.com

Received Date: 08 March 2017

摘要

摘要: 目的:比较OSAHS患者清醒和睡眠状态时上气道阻塞情况的VOTE评分。方法:经多导睡眠监测诊断为OSAHS的患者40例,分别进行清醒时Müller's检查及药物诱导睡眠内镜检查(DISE),并录像记录检查结果。统一使用VOTE评分系统描述检查过程中所观察到上气道的阻塞平面、阻塞程度及阻塞形态,比较两种检查结果的差异,并比较不同阻塞程度的患者间BMI、AHI、最低血氧饱和度及平均血氧饱和度是否存在差异。结果:清醒状态的Müller's检查主要观察到腭咽平面及口咽侧壁平面的阻塞,完全阻塞率分别为52.5%和30.0%。DISE结果提示40例OSAHS患者主要的上气道阻塞部位仍在腭咽平面,以完全阻塞为主(90.0%),其中以环形阻塞(95.0%)最为常见。口咽侧壁完全阻塞率为60.0%,舌根完全阻塞率为17.5%。根据VOTE评分,40例患者DISE检查在腭咽、口咽侧壁、舌根及会厌平面上的得分均高于清醒状态的Müller's检查,均差异有统计学意义(P＜0.05)。Müller's检查中,各平面不同阻塞程度患者间的BMI、AHI、最低血氧饱和度及平均血氧饱和度均无统计学差异(P＞0.05)。DISE检查结果中,腭咽平面,部分阻塞患者与完全阻塞患者的AHI值及最低血氧饱和度差异有统计学意义(P＜0.05);口咽侧壁、舌根及会厌平面,不同阻塞程度的患者间上述指标均无统计学差异(P＞0.05)。结论:OSAHS患者DISE检查VOTE评分明显高于Müller's检查,睡眠状态的上气道阻塞平面更多,阻塞程度更重。BMI、AHI、最低血氧饱和度及平均血氧饱和度与VOTE评分中的阻塞严重程度关联不明显。
- 睡眠呼吸暂停低通气综合征 /
- 阻塞性 /
- 药物诱导睡眠内镜检查 /
- Mü /
- ller's检查 /
- VOTE评分
Abstract: Objective: To compare the differences of the sites of airway obstruction in OSAHS patients between awake and sleep state by using the VOTE classification system.Method: Forty OSAHS patients diagnosed by PSG underwent awake Müller's maneuver and drug-induced sleep endoscopy(DISE).Video and compare the observation.Its findings were described using the VOTE classification system which include the following features:level,degree and configuration of obstruction.Associations were analyzed between different degrees of obstruction,BMI,AHI,minimal SaO₂ and average SaO₂.Result: Our patients had 52.5% complete velum collapse and 30.0% complete oropharyngeal lateral wall collapse in awake Müller's maneuver.In DISE,airway closure of 95.0% cases related to velum occurred collapse in concentric configuration,and 90.0% cases showed completely obstructive.We found that 60.0% complete oropharyngeal lateral wall collapse and 17.5% complete tongue base collapse.There was a significant difference in the VOTE scores between DISE and awake Müller's maneuver,and the VOTE scores of DISE were higher in all levels(P＜0.05).No association was found between degrees of obstruction,AHI,BMI,minimal SaO₂ and average SaO₂ in Müller's maneuver(P＞0.05).Complete velum collapse was just significantly associated with AHI and minimal SaO₂ in DISE(P＜0.05).Conclusion: The VOTE scores of DISE were higher than awake Müller's maneuver,reflected by more obstructive levels and severe degree.The difference between different degrees of obstruction,BMI,AHI,minimal SaO₂ and average SaO₂ was not significant.
- sleep apnea hypopnea syndrome /
- obstructive /
- drug-induced sleep endoscopy /
- Mü /
- ller's maneuver /
- VOTE classification system

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