OSAHS患者咽部解剖与呼吸驱动的关系研究

目的 探讨OSAHS患者咽腔形态与呼吸驱动(p0.1)的关系.方法 随机选取OSAHS患者35例,进行仰卧位睡眠状态下呼吸驱动测定及螺旋CT扫描,针对轻度(AHI ＜20)、中重度(AHI＞ 20)两组患者进行研究.结果 睡眠状态下,①中重度组软腭长度,软腭厚度,颏舌肌宽度及舌体面积明显增加(P＜0.05),软腭后区最小气道面积明显减小(P＜0.05)；②中重度组P0.1的下降更为明显(P＜0.05).③中重度组颏舌肌宽度与P0.1有明显负相关性(r=-0.574,P＜0.05).结论 睡眠状态下,咽腔狭窄程度与OSAHS病情相关,随着OSAHS患者病情加重,颏舌肌的代偿作用增加,当代偿到一定程度时出现呼吸驱动的降低.

The relationship between breathing control (P0.1) and anatomic measurements of the upper airway in patients with Obstructive Sleep Apnea-hypopnea Syndrome(OSAHS)

Objective To determine the correlation of the breathing control and anatomic measurements of upper airway with disease activity using a cross-sectional pilot study in outpatients with OSAHS.Methods 35 OSAHS patients were studied.And they were subdivided into two groups by AHI:mild group(520).Polysomnography,breathing control and CT of the upper airway during sleep periods were performed in both groups at supine position without oxygen.All parameters were compared between the two groups.Results In sleeping without Oxygen,comparative results of different AHI were as follows:①Tongue area,width and height of soft palate,and Genioglossal(GG) width in AHI>20 group were larger(P<0.05),and the former had the smaller minimum area of retropalatal region(P<0.05).②P0.1 showed lower in AHI>20(P<0.05).③Correlation analysis showed that P0.1 was negatively correlated with GG width(r=-0.574,P<0.05) for patients of AHI>20 group.Conclusion There are some differences of pharyngeal morphology between the two groups in sleeping.And with the increase of AHI,the compensation activity of GG increases,but the impulse to the cerebral cortex disappear when GG width is at a certain extent,and the respiratory driver dropes even more.