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目的:通过分析OSAHS患儿不同呼吸时相腺样体-鼻咽腔比率(A/N比率)与睡眠呼吸监测指标的相关性,评估动态A/N比率在OSAHS患儿疾病评估中的应用价值。方法:51例单纯腺样体肥大的OSAHS患儿,利用磁共振结合呼吸门控技术对各呼吸时相(吸气初、中、末及呼气初、中、末)上气道进行动态扫描,并测定A/N比率,分析不同呼吸时相的A/N比率与睡眠呼吸监测指标AHI和LaSO_2的相关性,并通过ROC曲线和Kappa分析分别确定A/N比率在儿童OSAHS病情严重程度评估中的临界值及诊断符合率。结果:OSAHS患儿6个呼吸时相A/N比例均与AHI呈显著正相关(均P<0.01),其中呼气末A/N比率与AHI相关性最高(r=0.559 4)。此外,ROC曲线发现,呼气末A/N比率诊断病情轻-中度及重度的最佳临界值为0.834,两者的符合率分别为81%和84%。结论:通过磁共振结合呼吸门控技术获取动态A/N比率可作为儿童OSAHS诊断的重要影像学手段,且呼气末A/N比率有望成为儿童轻-中度和重度OSAHS的临床影像学分类指标。
OBJECTIVE: To evaluate the value of dynamic A / N ratio in the assessment of disease in children with OSAHS by analyzing the correlation of respiratory phase AOA-nasopharyngeal ratio (A / N ratio) with sleep-respiration monitoring in children with OSAHS . Methods: Fifty-one children with OSAHS with adenoid hypertrophy were enrolled in this study. The airway of each OSAHS (early, middle, end of breath, and early, middle and last breath) were scanned dynamically by magnetic resonance , And the A / N ratio was determined. The correlation between A / N ratio and AHI and LaSO 2 in different respiration phases was analyzed. The severity of OSAHS in children was assessed by ROC curve and Kappa analysis respectively In the critical value and diagnosis coincidence rate. Results: There was a significant positive correlation between A / N ratio and AHI in six respiratory OSAHS patients (all P <0.01). The A / N ratio of end-expiratory was the highest correlated with AHI (r = 0.559 4). In addition, the ROC curve found that the best cut-off value of end-tidal A / N ratio of mild to moderate and severe was 0.834, the coincidence rates were 81% and 84% respectively. Conclusion: The dynamic A / N ratio obtained by magnetic resonance combined with respiratory gating technique can be used as an important imaging method in the diagnosis of OSAHS in children, and the end-tidal A / N ratio is expected to be the clinical imaging classification of mild-moderate and severe OSAHS in children index.