Obstructive sleep apnoea in acromegaly: the role of craniofacial changes
Obstructive sleep apnoea in acromegaly: the role of craniofacial changes
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DOI：
10.1034/j.1399-3003.1999.14a33.x
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发表时间：
1999-07-01
影响因子：
24.3
通讯作者：
Brandenburg, U
中科院分区：
文献类型：
--
作者：
Hochban, W;Ehlenz, K;Brandenburg, U
阻塞性睡眠呼吸暂停（OSA）是由颅面改变和肢端肥大症引起的。本研究提出的问题是，生长激素（GH）诱导的颅面改变是否可以解释肢端肥大症患者尽管内分泌不活跃但持续存在的OSA。我们对19例肢端肥大症患者进行了颅面改变的颅面测量和OSA的多导睡眠描记检查。12例患者被证实患有OSA，呼吸暂停/呼吸不足指数bbb15；7名患者完全没有阻塞性睡眠呼吸暂停的迹象。在内分泌参数方面，两组之间没有差异可以解释是否存在OSA。两组在性别、年龄或体重指数方面都没有差异。颅面改变主要见于下颌骨。与未患阻塞性睡眠呼吸暂停的人相比，患有阻塞性睡眠呼吸暂停的那组人的垂直面部生长有所增加。随后，OSA组后气道间隙变窄，舌骨向后侧移位。因此，肢端肥大症和持续性阻塞性睡眠呼吸暂停患者的颅面结构似乎与非阻塞性睡眠呼吸暂停患者不同。对肢端肥大症引起的颅面改变进行手术矫正时，应注意个体颅面状况，以免加重阻塞性睡眠呼吸暂停。
Obstructive sleep apnoea (OSA) is due to craniofacial changes and acromegaly. The question addressed by this study was whether growth hormone (GH) induced craniofacial changes might explain persisting OSA despite endocrine inactivity in acromegaly.Nineteen patients treated for acromegaly were examined cephalometrically for craniofacial changes and polysomnographically for OSA. Twelve patients proved to have OSA with an apnoea/hypopnoea index >15; seven patients showed no evidence of OSA at all.With respect to the endocrinological parameters, there were no differences between the two groups that would explain the presence or absence of OSA. Neither group differed with respect to sex, age, or body mass index. Craniofacial changes were predominantly found in the mandible. The group,vith OSA proved to have increased vertical, dolichofacial growth compared to those without OSA. Consecutively, in the OSA group the posterior airway space was narrowed, and the hyoid was displaced more caudally.Thus, it seems that craniofacial structures of patients,vith acromegaly and persisting obstructive sleep apnoea are different from those without obstructive sleep apnoea. Surgical corrections of pertaining acromegaly-induced craniofacial changes should be performed with an awareness of the individual craniofacial condition so as not to enhance obstructive sleep apnoea.