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目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)单纯鼾症患者及正常人之间咽腔截面积的大小和可塌陷性的情况。方法对171例OSAHS患者(轻度44例、中度51例、重度76例),47例单纯鼾症患者和47例正常人的上气道进行声反射测定,记录肺容积在功能残气位(FRC)和残气位(RV)时的曲线。结果FRC时咽腔截面积单纯鼾症组(2.63 cm2±0.42 cm2),轻、中、重度OSAHS组(2.70 cm2±0.44 cm2,2.62 cm2±0.52 cm2和2.57 cm2±0.46 cm2)均小于正常对照组(3.05 cm2±0.6 cm2)(均P<0.05)。当肺容积从FRC降至RV时,单纯鼾症组,轻、中、重度OSAHS组和正常对照组(从2.63 cm2±0.42 cm2降至1.96 cm2±0.35 cm2,2.70 cm2±0.44 cm2降至1.78 cm2±0.39 cm2,2.62 cm2±0.52 cm2降至1.79 cm2±0.37 cm2,2.57 cm2±0.46 cm2降至1.75 cm2±0.40 cm2和3.05 cm2±0.6 cm2降至2.38 cm2±0.47 cm2)咽腔截面积均降低,且轻、中、重度OSAHS组(33.93%±11.81%,31.13%±10.76%和31.31%±13.44%)和单纯鼾症组(25.07%±10.39%)咽腔截面积降低程度均明显大于正常对照组(21.11%±8.19%)(均P<0.05),而OSAHS组降低的程度更大。结论鼾症患者无论其是否伴有OSAHS其咽腔截面积在FRC时是相似的,都比正常人小,当肺容积从FRC降至RV时轻、中、重OSAHS患者和单纯鼾症患者咽腔可塌陷性均明显大于正常人,而OSAHS患者咽腔可塌陷性更大。
Objective To investigate the size and collaptility of the pharyngeal cavity in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients with simple snoring and normal subjects. Methods The airway of 171 patients with OSAHS (mild 44, moderate 51, severe 76), 47 patients with simple snoring and 47 normal subjects were measured by acoustic reflectometry. (FRC) and residual gas (RV) curve. Results In the FRC group, the pharyngeal cavity area of the simple snoring group (2.63 cm2 ± 0.42 cm2), mild, moderate and severe OSAHS group (2.70 cm2 ± 0.44 cm2, 22.62 cm2 ± 0.52 cm2 and 2.57 cm2 ± 0.46 cm2) were less than the normal control group (3.05 cm2 ± 0.6 cm2) (all P <0.05). When the lung volume decreased from FRC to RV, the incidences of simple snoring group, mild, moderate and severe OSAHS group and normal control group (from 2.63 cm2 ± 0.42 cm2 to 1.96 cm2 ± 0.35 cm2, 2.70 cm2 ± 0.44 cm2 to 1.78 cm2 ± 0.39 cm2,2.62 cm2 ± 0.52 cm2 to 1.79 cm2 ± 0.37 cm2, 2.57 cm2 ± 0.46 cm2 to 1.75 cm2 ± 0.40 cm2 and 3.05 cm2 ± 0.6 cm2 to 2.38 cm2 ± 0.47 cm2) The pharyngeal cross-sectional area decreased, The reduction of pharyngeal cross-sectional area in OSAHS group (33.93% ± 11.81%, 31.13% ± 10.76% and 31.31% ± 13.44%) and simple snoring group (25.07% ± 10.39%) were significantly greater than those in normal controls Group (21.11% ± 8.19%) (all P <0.05), while OSAHS group decreased more. Conclusions Snoring patients with or without OSAHS have similar pharyngeal cross-sectional area at FRC and are smaller than normal controls. Patients with mild, moderate, and severe OSAHS and patients with simple snoring, when the lung volume decreases from FRC to RV, The collapse of the cavity was significantly greater than normal, but the OSAHS patients collapsed larger pharynx.