OBSTRUCTIVE SLEEP-APNEA AND CEPHALOMETRIC ROENTGENOGRAMS - THE ROLE OF ANATOMIC UPPER AIRWAY ABNORMALITIES IN THE DEFINITION OF ABNORMAL BREATHING DURING SLEEP
OBSTRUCTIVE SLEEP-APNEA AND CEPHALOMETRIC ROENTGENOGRAMS - THE ROLE OF ANATOMIC UPPER AIRWAY ABNORMALITIES IN THE DEFINITION OF ABNORMAL BREATHING DURING SLEEP
复制标题
DOI：
10.1378/chest.93.6.1199
复制
发表时间：
1988-06-01
期刊：
影响因子：
9.6
通讯作者：
JAMIESON, A
中科院分区：
文献类型：
--
作者：
PARTINEN, M;GUILLEMINAULT, C;JAMIESON, A
在六个月的时间内，连续就诊的 157 名阻塞性睡眠呼吸暂停综合征 (OSAS) 患者接受了标准化头影测量 X 线检查，并在睡眠期间接受了多描记监测。对不同的变量，包括头影测量标志、体重指数（BMI）和测谎结果（特别是氧饱和度和异常呼吸事件的数量）进行了统计分析。一般来说，OSAS 患者存在上呼吸道解剖异常和 BMI 升高：大量肥胖与较少的解剖异常、较少的夜间睡眠中断和较长的总睡眠时间 (TST) 相关。呼吸障碍指数（RDI）高的患者更有可能出现上呼吸道解剖异常；他们的睡眠时间较短，第一阶段非快速眼动 (NREM) 睡眠增加，但第三阶段和第四阶段以及快速眼动睡眠减少。长下颌平面到舌骨 (MP-H) 的距离和后气道间隙 (PAS)（舌根后面的空间）的宽度是 RDI 升高的统计学显着预测因素。头影测量变量对于预测 O2 饱和度降至 80% 以下的频率的作用要小得多。患者群体可细分为（a）具有明显解剖异常和低 BMI 的患者，（b）具有很少异常头影测量值的病态肥胖患者，以及（c）BMI 不同程度增加和异常头影测量值的患者。这是最大的群体。我们得出的结论是，标准化头影测量 X 线照片可有助于确定 OSAS 患者的适当治疗方法。
In a six-month period, 157 obstructive sleep apnea syndrome (OSAS) patients seen consecutively in clinic had standardized cephalometric roentgenograms and underwent polygraphic monitoring during sleep. Different variables, including cephalometric landmarks, body mass index (BMI), and polygraphic results (particularly degree of O2 saturation and number of abnormal breathing events), were statistically analyzed. As a rule, OSAS patients had upper airway anatomic abnormalities and an elevated BMI: massive obesity was associated with less anatomic abnormality, less nocturnal sleep disruption, and longer total sleep time (TST). Patients having a high respiratory disturbance index (RDI) were more likely to have upper airway anatomic abnormalities; they slept for a shorter time and had increased stage I non-rapid eye movement (NREM) sleep but decreased stage 3 and 4 and REM sleep. Long mandibular plane to hyoid bone (MP-H) distance and width of the posterior airway space (PAS) (space behind the base of the tongue) were statistically significant predictors of elevated RDI. The cephalometric variables were much less useful for predicting frequency of O2 saturation drops below 80 percent. The patient population can be subdivided into (a) patients with clear anatomic abnormalities and low BMI, (b) patients with morbid obesity with few abnormal cephalometric measurements, and (c) patients who have variably increased BMI and abnormal cephalometric measurements. This is the largest group. We concluded that standardized cephalometric roentgenograms can be useful in determining the appropriate treatment for OSAS patients.