上气道咽壁顺应性的多层螺旋CT研究

摘要

目的：探讨上气道咽壁顺应性对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的影响。方法对68例OSAHS患者和65例健康志愿者分别在平静呼吸、闭口堵鼻深吸气（Müller’s）时相于清醒状态下行多层螺旋CT上气道仰卧位扫描，测量两个呼吸时相鼻咽区、腭咽区、舌咽区和会厌区的咽壁总顺应性、咽侧壁顺应性及前后壁顺应性。结果 OSAHS组和对照组上气道咽腔各区咽壁顺应性均有所不同，鼻咽区最小，舌咽及会厌区次之，腭咽区最大；OSAHS组与对照组比较，鼻咽区两组间咽壁总顺应性、咽侧壁顺应性、前后壁顺应性差异无统计学意义（P>0.05），余咽区两组间差异均有统计学意义（腭咽区、舌咽区P<0.01；会厌区P<0.05）。结论咽壁顺应性增高是OSAHS的重要原因之一，探究OSAHS患者上气道咽壁顺应性增高的原因对临床选择合适的治疗方案具有重要指导作用。%Objective To investigate the infl uence of pharyngeal wall compliance of upper airway to obstructive sleep apnea hypopnea syndrome (OSAHS).Methods68 cases with OSAHS and 65 cases with controls were scanned by MSCT in two respiratory phases of calm respiration and Müller action at awake state in supine position of upper airway. The total pharyngeal wall compliance(TPWC),lateral pharyngeal wall compliance (LPWC) and anteroposterior pharyngeal wall compliance(APPWC) of nasopharyngeal,velopharyngeal,glossopharyngeal and epiglottis area were measured in two respiratory phases.Results Regardless of the OSAHS or the controls,the pharyngeal wall compliance were different in every area of pharyngeal cavity,which is the least in nasopharyngeal area,less in glossopharyngeal and epiglottis area,and the largest in velopharyngeal area. The OSAHS compared with the controls,the TPWC,LPWC and APPWC of two groups had statistical significance in velopharyngeal, glossopharyngeal and epiglottis area(P<0.01 in velopharyngeal,glossopharyngeal area,P<0.05 in epiglottis area) and had no statistical signifi cance in nasopharyngeal area(P>0.05).Conclusion Increased pharyngeal wall compliance was a major reason of OSAHS,and exploring the cause of increasing pharyngeal wall compliance in upper airway of OSAHS patients has important role for clinical treatment.