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目的研究阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopneasyndrome,OSAHS)患者舌腭关系分型与舌后区上呼吸道狭窄的关系。方法经多道睡眠监测确诊的OSAHS 患者共100例,采用螺旋 CT 对上呼吸道进行连续扫描,对舌后区呼吸道各参数进行测量,对比研究不同 Friedman 舌腭关系分型组间舌后区呼吸道各测量参数和舌后区呼吸道狭窄发生率的差别,并采用多元逐步回归分析探讨影响舌腭关系分型的因素。结果不同舌腭关系分型的 OSAHS 患者的一般临床资料无统计学差异(P 值均>0.05),从舌腭关系Ⅰ型到Ⅳ型,舌后区呼吸道截面积和内径逐渐缩小,舌体长度和舌截面积逐渐增加,舌后区呼吸道狭窄的发生率逐渐增高,Ⅰ型到Ⅳ型患者组中发生舌后区呼吸道狭窄的比率分别为0/25、3/39、7/22、14/14,差异有统计学意义(P 值均<0.05)。多元逐步回归分析证实影响舌腭关系分型最显著因素为舌后区呼吸道截面积,偏回归系数为-0.39,复相关系数为-0.545。,结论舌腭关系分型与舌后区呼吸道狭窄有明显相关关系,临床可以通过对舌腭关系分型的观察来初步判断舌后区呼吸道状态。
Objective To investigate the relationship between tongue and palate relationship and upper respiratory tract stenosis in the posterior tongue region of patients with obstructive sleep apnea hypopneasy syndrome (OSAHS). Methods A total of 100 patients with OSAHS diagnosed by multi-sleep monitoring were enrolled in this study. The upper respiratory tract was continuously scanned by spiral CT, and the parameters of the respiratory tract in the posterior lingual tongue were measured. The airway posterior region of each Friedman tongue-palate relationship group The differences between the parameters and the incidence of respiratory tract stenosis in the posterior lingual region were measured and multivariate stepwise regression analysis was used to explore the factors influencing the classification of the tongue-palatine relationship. Results The clinical data of OSAHS patients with different types of tongue and palate relationship showed no significant difference (P> 0.05). From the tongue type Ⅰ to the type Ⅳ, the cross sectional area and the inner diameter of the respiratory tract in the lingual tongue area gradually decreased, And tongue cross-sectional area increased gradually, the incidence of respiratory tract stenosis in the posterior lingual region gradually increased, and the ratio of respiratory tract stenosis in the posterior lingual region of type Ⅰ to Ⅳ was 0 / 25,3 / 39,7 / 22,14 / 14, the difference was statistically significant (P <0.05). Multivariate stepwise regression analysis confirmed that the most significant factor influencing the classification of tongue-palate relationship was the respiratory tract cross-sectional area in the posterior lingual tongue, with a partial regression coefficient of -0.39 and a complex correlation coefficient of -0.545. , Conclusion The classification of tongue and palate relationship is closely related to the narrowing of the respiratory tract in the posterior lingual tongue. Clinically, the state of the respiratory tract in the posterior lingual tongue may be preliminarily determined through the observation of the classification of the tongue and palate relationship.