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目的 :比较阻塞性睡眠呼吸暂停 (obstructive sleep apnea,OSA)患者、打鼾者与正常对照的颌面结构 ,以探讨 OSA的发病过程及可能机制。 方法 :研究对象为 86例男性 OSA患者 ,45例男性打鼾者及 37例健康成年男性 ,均行多导睡眠仪检查证实或排除 OSA;用数字化技术摄取头颅侧位片 ,应用 NIH Im age软件测定骨性结构、软组织结构、舌骨位置、咽部口径参数等 2 3项。 结果 :OSA患者、打鼾者的骨性结构、软组织结构、舌骨位置、咽部口径均存在异常 ,其中舌长度、口腔外舌面积、舌骨位置、腭水平口咽部口径 ,在对照组、OSA患者与打鼾者之间差异均显著 ,经身高、体重指数 (BMI)校正后 ,除舌长度、部分舌骨位置参数外结果基本不变。多元逐步回归分析提示 ,肥胖程度、上颌骨缺陷、软腭舌接触面长度、咽部长度对 OSA严重度影响较大。 结论 :打鼾者与 OSA患者同样存在颌面结构的异常 ,其中部分软组织相关参数介于 OSA患者和正常人之间 ,软组织的变化可能在 OSA发生发展中起着一定作用。
OBJECTIVE: To compare the maxillofacial structures of patients with obstructive sleep apnea (OSA), snorers and normal controls to explore the pathogenesis of OSA and its possible mechanism. METHODS: A total of 86 OSA patients, 45 male snorers, and 37 healthy adult men were enrolled in this study. All patients underwent polysomnography to confirm or exclude OSA. The cephalometric slices were taken by digital technique and measured by NIH Im age software Bone structure, soft tissue structure, hyoid position, pharyngeal caliber parameters such as 23 items. Results: Osseous structure, soft tissue structure, hyoid position and pharyngeal diameter of OSA patients and snorers were all abnormal. The length of tongue, the area of oral tongue, the position of hyoid bone, There was significant difference between OSA patients and snorers. After adjusting for height and body mass index (BMI), the results except for the tongue length and some hyoid position parameters were basically unchanged. Multivariate stepwise regression analysis showed that degree of obesity, maxillary defects, soft palate tongue contact surface length, pharyngeal length on OSA severity greater impact. CONCLUSIONS: There are also maxillofacial abnormalities in snorers and OSA patients. Some soft tissue parameters are between OSA patients and normal controls. The changes of soft tissue may play a role in the development of OSA.