CAJ | 학술논문

目的：???应用X线头影测量结合Müller试验分析不同肥胖程度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的颅颌面结构、上气道软组织解剖结构的差异，并评价肥胖对OSAHS患者上气道可塌陷性的影响。方法??收集男性患者39例，记录其基本生理信息，多导睡眠监测结果，平静呼气末及Müller相侧位片。以体重指数（BMI）24?kg?m-2为界对纳入人群进行分类，分为正常体重组12人，肥胖+超重组27人。应用Cassos?2001计算机辅助测量软件对Müller试验实施前后患者颅颌面软硬组织和上气道及周围组织结构进行数据测量，并进行统计分析。结果???肥胖+超重组OSAHS患者与正常体重组相比，其颅颌面硬组织差异不明显，而在上气道及周围组织特征上，肥胖+超重组表现为上气道各平面矢状径均增大，其中在腭后区、腭尖平面及舌后区差异显著。除此之外，在肥胖+超重组中，实施Müller试验后患者上气道各层面塌陷显著，但正常体重组不明显。结论???肥胖OSAHS患者与正常体重患者的致病因素可能存在差别，上气道管腔对负压的敏感性增加可能是促成肥胖伴OSAHS的病因之一。
목적：???응용X선두영측량결합Müller시험분석불동비반정도조새성수면호흡잠정저통기종합정（OSAHS）환자적로합면결구、상기도연조직해부결구적차이，병평개비반대OSAHS환자상기도가탑함성적영향。방법??수집남성환자39례，기록기기본생리신식，다도수면감측결과，평정호기말급Müller상측위편。이체중지수（BMI）24?kg?m-2위계대납입인군진행분류，분위정상체중조12인，비반+초중조27인。응용Cassos?2001계산궤보조측량연건대Müller시험실시전후환자로합면연경조직화상기도급주위조직결구진행수거측량，병진행통계분석。결과???비반+초중조OSAHS환자여정상체중조상비，기로합면경조직차이불명현，이재상기도급주위조직특정상，비반+초중조표현위상기도각평면시상경균증대，기중재악후구、악첨평면급설후구차이현저。제차지외，재비반+초중조중，실시Müller시험후환자상기도각층면탑함현저，단정상체중조불명현。결론???비반OSAHS환자여정상체중환자적치병인소가능존재차별，상기도관강대부압적민감성증가가능시촉성비반반OSAHS적병인지일。
Objective???To?evaluate?the?changes?in?upper?airway?and?surrounding?structures?under?intraluminal?pressure?using?cephalometry?with?Müller’s?maneuver?in?obese?and?overweight?obstructive?sleep?apnea?and?hypopnea?syndrome(OSAHS)?patients?and?non-obese?controls.?Methods???Thirty-nine?male?patients?were?enrolled,?anthropometric?measurements?and?polysomnography?data?were?collected?prior?to?the?study.?Lateral?cephalograms?of?each?patient?were?obtained?either?at?the?end-expiration?phase?or?the?Müller’s?maneuver?phase.?The?patients?included?in?the?study?were?classified?into?two?groups?according?to?the?body?mass?index(BMI).?The?BMI?of?patients?<24?kg?m-2?was?regarded?as?normal?group,?including?12?cases;?while?the?obese?group?includes?27?cases.?Craniofacial?and?upper?airway?structures?were?measured?in?lateral?cephalometry?using?Cassos?2001?computed?aided?measurement?software?before?and?after?the?patients’?practicing?the?Müller’s?maneuver.?Results??Two?groups?are?similar?in?the?craniofacial?hard?bony?structures.?However,?when?compared?with?the?upper?airway?and?surrounding?structures,?the?obesity?group?exhibits?a?wider?anterior-posterior?dimension?of?upper?airway,?especially?significant?in?retropalatal,?tip?of?the?palatal,?retroglossal?area.?In?addition,?the?obesity?group?shows?a?more?collapsible?airway?than?the?controls?after?practicing?the?Müller’s?maneuver. Conclusion???The?pathogenesis?of?OSAHS?in?obese?patient?may?different?from?the?patients?of?normal?weight.?The?increased?compliance?to?negative?intraluminal?pressure?may?predispose?to?the?onset?of?OSAHS?with?obese?status.