动态腺样体-鼻咽腔比率在OSAHS患儿疾病评估中的应用研究

曾国辉; 李郧; 滕尧树; 朱瑾

doi:10.13201/j.issn.1001-1781.2017.15.008

动态腺样体-鼻咽腔比率在OSAHS患儿疾病评估中的应用研究

- 1. 浙江中医药大学附属杭州第一医院杭州市第一人民医院耳鼻咽喉头颈外科(杭州, 310006);
- 2. 深圳市宝安区福永人民医院耳鼻咽喉头颈外科

详细信息

通讯作者: 朱瑾,E-mail:zhujin2698@163.com

中图分类号: R563.8

收稿日期: 2017-05-07

Clinical application of the dynamic adenoidal-hypertrophy ratio in the evaluation of illness severity in children with OSAHS

- 1. Department of Otorhinolaryngology Head and Neck Surgery, Hangzhou First People's Hospital, Hangzhou, 310006, China;
- 2. Department of Otorhinolaryngology Head and Neck Surgery, Baoan District Fuyong People's Hospital in Shenzhen

More Information

Corresponding author: ZHU Jin, E-mail: zhujin2698@163.com

Received Date: 07 May 2017

摘要

摘要: 目的：通过分析OSAHS患儿不同呼吸时相腺样体-鼻咽腔比率（A/N比率）与睡眠呼吸监测指标的相关性，评估动态A/N比率在OSAHS患儿疾病评估中的应用价值。方法：51例单纯腺样体肥大的OSAHS患儿，利用磁共振结合呼吸门控技术对各呼吸时相（吸气初、中、末及呼气初、中、末）上气道进行动态扫描，并测定A/N比率，分析不同呼吸时相的A/N比率与睡眠呼吸监测指标AHI和LaSO₂的相关性，并通过ROC曲线和Kappa分析分别确定A/N比率在儿童OSAHS病情严重程度评估中的临界值及诊断符合率。结果：OSAHS患儿6个呼吸时相A/N比例均与AHI呈显著正相关（均P<0.01），其中呼气末A/N比率与AHI相关性最高（r=0.559 4）。此外，ROC曲线发现，呼气末A/N比率诊断病情轻-中度及重度的最佳临界值为0.834，两者的符合率分别为81%和84%。结论：通过磁共振结合呼吸门控技术获取动态A/N比率可作为儿童OSAHS诊断的重要影像学手段，且呼气末A/N比率有望成为儿童轻-中度和重度OSAHS的临床影像学分类指标。
- 睡眠呼吸暂停低通气综合征,阻塞性 /
- 睡眠呼吸监测 /
- 腺样体 /
- 核磁共振成像
Abstract: Objective: To evaluate application value of the dynamic adenoidal-hypertrophy (A/N) ratio in children with OSAHS by analyzing the correlation between the A/N ratio at thedifferent respiratory phases and the index of polysomnography.Method: Fifty-one childrens, with simple hypertrophic adenoids, were diagnosed as OSAHS. Magnetic resonance imaging(MRI) with respiratory gating technology were used to scan the upper airway of children during sleep at the early, middle and end phases of respiratory cycle, and measure adenoidal-hypertrophy ratio in different respiratory phases. The correlation analysis was performedbetween the A/N ratio in different respiratory phases and the index of polysomnography(AHI and LaSO₂).Finally, via ROC curve and Kappa analysis, the critical value and diagnosis accordance rate of A/N ratio in illness severity evaluation of children with OSAHS were confirmed.Result: At the 6 respiratory phases,the A/N ratios showed significantly positive correlations with AHI (All P<0.01).There was a highest coefficient between the end-expiratory A/N ratio and AHI(r=0.559 4).In addition, the optimal cut-off point of A/N ratio between slight-moderate and severe OSAHS was 0.834. The diagnosis accuracies of the end-expiratory A/N ratio in severe and slight-moderate OSAHS were 81% and 84%, respectively.Conclusion: MRI with respiratory gating technology obtaining dynamic A/N ratio might be an important method of imaging diagnosis of children OSAHS, and the end expiratory A/N ratio is expected to become a classification index of slight-moderate and severe children OSAHS.
- sleep apnea hypopnea syndrome,obstructive /
- polysomnography /
- adenoid /
- magnetic resonance imaging

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