动态腺样体-鼻咽腔比率在OSAHS患儿疾病评估中的应用研究

发布时间：2018-05-11 07:25

本文选题：睡眠呼吸暂停低通气综合征 + 阻塞性　；参考：《临床耳鼻咽喉头颈外科杂志》2017年15期

【摘要】：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P0.01),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。
[Abstract]:Objective: to evaluate the value of dynamic A / N ratio in evaluating the disease of children with OSAHS by analyzing the correlation between the ratio of adenoid to nasopharyngeal cavity ratio (A / N ratio) and sleep respiratory monitoring index in children with OSAHS. Methods 51 cases of OSAHS with simple adenoid hypertrophy were examined by magnetic resonance imaging (MRI) combined with respiratory gating technique. The upper airway was dynamically scanned at the beginning, middle, end and end of breath, and the ratio of A / N was measured. The correlation between the ratio of A / N in different breathing phases and the indexes of AHI and LaSO_2 was analyzed. The critical value and diagnostic coincidence rate of A / N ratio in evaluating the severity of OSAHS in children were determined by ROC curve and Kappa analysis respectively. Results there was a significant positive correlation between the ratio of A / N in 6 breathing phases and AHI (all P 0.01). The ratio of end-expiratory A / N had the highest correlation with AHI (r = 0.559 4). In addition, the best critical value of end-expiratory A / N ratio for the diagnosis of mild to moderate and severe disease was 0.834, and the coincidence rates were 81% and 84%, respectively. Conclusion: the dynamic A / N ratio can be used as an important imaging method for the diagnosis of OSAHS in children by Mr and respiratory gated technique, and the end-expiratory A / N ratio is expected to be the clinical imaging classification index of mild to moderate and severe OSAHS in children.
【作者单位】：浙江中医药大学附属杭州第一医院杭州市第一人民医院耳鼻咽喉头颈外科;深圳市宝安区福永人民医院耳鼻咽喉头颈外科;
【分类号】：R766

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