阻塞性睡眠呼吸暂停低通气综合征与颞下颌关节相关性研究

发布时间：2018-06-13 23:44

  本文选题：阻塞性睡眠呼吸暂停低通气综合征 + 颞下颌关节　； 参考：《中国人民解放军医学院》2017年硕士论文

【摘要】：第一部分阻塞性睡眠呼吸暂停低通气综合征患者颞下颌关节间隙测量目的通过对阻塞性睡眠呼吸暂停低通气综合征患者的颞下颌关节行磁共振扫描分析,探讨OSAHS患者与正常人群的颞下颌关节形态学差异。方法选取2014年1月至2016年5月收治的18例OSAHS患者和18例健康成人,分别记为研究组(n=18 )和对照组(n=18 ),再按照呼吸暂停及低通气指数(apnea andhypopneaindex,AHI)将OSAHS患者分为轻、中、重3个亚组(n=6)。对所有纳入人群行TMJ的磁共振(Magnetic Resonance Imaging, MRI)扫描并测量关节间隙,并采用spss17.0软件包对测量数据行统计学处理,组间计量资料行独立样本t检验,计数资料行χ2检验,多组间比较采用单因素方差分析。结果①2组患者在年龄、性别构成比例、关节上间隙及髁突有无移位方面差异均无统计学意义(P 0. 05 )。②OSAHS患者TMJ左侧前间隙[(2.61 ± 0.19)mm :(2.47 ± 0. 18)mm,P0.05]、右侧前间隙[(2.63 ± 0.18)mm : ( 2.48 ± 0. 17)mm,P0.05]大于正常人群。OSAHS患者TMJ左侧后间隙[(2.43 ± 0.20)mm : ( 2.51 ±0.19)mm,P0.05]、右侧后间隙[(2.44±0.20)mm : ( 2.60 ± 0.13)mm,P0.05]小于正常人群。③轻度OSAHS组TMJ左侧前间隙[(2.53 ± 0.26)mm : ( 2.73 ±0.07)mm,P0.05]、右侧前间隙[(2.54 ± 0.11)mm : ( 2.74 ± 0.14)mm,P0.05]均小于重度组;轻度OSAHS组TMJ左侧后间隙[(2.56 ± 0.29)mm : ( 2.29 ±0.09)mm,P0.05]、右侧后间隙[(2.55±0.23)mm : ( 2.31 ± 0.09)mm,P0.05]均大于重度组。结论OSAHS患者的髁突相较于正常人群位于关节窝偏后位置。髁突位于关节窝偏后位置的趋势与OSAHS严重程度相关。第二部分OSAHS患者与正常人群RDC/TMD轴Ⅰ诊断对比目的分析我国阻塞性睡眠呼吸暂停低通气综合征患者与正常人群颞下颌关节紊乱病的流行病学差异。方法将2015年11月至2016年11月至我院就诊OSAHS患者及正常人群按1:1行个体配对,分别记为OSAHS组(n=64)和对照组(n=64)。应用陈伟生等建立的颞下颌关节紊乱病研究诊断标准(RDC/TMD)轴Ⅰ中文版,对2组人群进行临床检查以及调查问卷填写,根据结果进行诊断分类,包括第一组诊断:肌病类;第二组诊断:关节盘移位类:第三组诊断:关节痛、关节炎、关节病类。采用spss17.0软件包对测量数据行统计学处理,计数资料行χ2检验。结果①共有138例受试者完成调查,有效量表128例,其中男98例,女30例,男女比例3.3:1,年龄、性别构成比例差异无统计学意义(P0. 05)。②2组人群TMD患病率及各亚型诊断间差异均无统计学意义(P 0. 05)③.22/64 vs.12/64,(P0.05)方面大于正常人群,差异有统计学意义。结论OSAHS患者的TMD亚型诊断较正常人群复杂。OSAHS患者一旦合并TMD,将面临较正常人群更为严重的TMD发展趋势。
[Abstract]:The first part: temporomandibular joint space measurement in patients with obstructive sleep apnea hypopnea syndrome objective to analyze the temporomandibular joint in patients with obstructive sleep apnea hypopnea syndrome by magnetic resonance imaging. Objective: to investigate the morphological differences of temporomandibular joint between OSAHS patients and normal subjects. Methods from January 2014 to May 2016, 18 OSAHS patients and 18 healthy adults were selected as study group (n = 18) and control group (n = 18). According to apnea and hypopnea index (AHII), OSAHS patients were divided into three subgroups: mild, moderate and heavy. All subjects were scanned and measured by magnetic resonance imaging (MRI) of TMJ. The measured data were statistically processed by spss17.0 software package, independent sample t-test was performed among groups, and 蠂 2 test was performed for counting data. Single factor analysis of variance (ANOVA) was used for multi-group comparison. Results there were no significant differences in age, sex ratio, supraarticular space and condylar process displacement in 12 groups. Left anterior space of TMJ [2.61 卤0.19)mm: 2.47 卤0. The right anterior space [2.63 卤0.18)mm: (2.48 卤0)]. The left posterior space of OSAHS patients was significantly higher than that of normal subjects [2.43 卤0.20)mm: (2.51 卤0.19mm) P0.05], and the right posterior space [2.44 卤0.20)mm: (2.60 卤0.13mm) P0.05] was lower than that of normal subjects [2.53 卤0.26)mm: 2.73 卤0.07mm], and the right anterior space was 2.54 卤0.11)mm. 卤0.14 卤0.14 mm (P0.05) was lower than that in severe group. In the mild OSAHS group, the left posterior space of TMJ [2.56 卤0.29)mm: (2.29 卤0.09) 0.29)mm], and the right posterior space [2.55 卤0.23)mm: (2.31 卤0.09) 0.29)mm] were higher than those in the severe group. Conclusion the condyle of OSAHS patients is located in posterior position of articular fossa. The tendency of condylar process in the posterior position of articular fossa is related to the severity of OSAHS. Part two: comparative diagnosis of RDC / TMD axis 鈪，

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