肥胖青少年上气道结构和体脂构成与阻塞性 睡眠呼吸暂停的相关性研究

Study on correlation between obstructive sleep apnea and upper airway structure and body fat composition in obese adolescents

摘要:

摘要：目的判定肥胖青少年发生阻塞性睡眠呼吸暂停的解剖危险因素。方法收集24例发生阻塞性睡眠呼吸暂停的肥胖青少年组(人体质量指数BMI Z分数： 2.2±0.4)和24例肥胖对照组(人体质量指数BMI Z分数： 2.1±0.3)的相关临床资料，通过磁共振影像测量两组肥胖青少年的上气道结构以及体脂构成，并应用多因素回归分析与条件Logistic回归进行统计学分析。结果与对照组相比，患有阻塞性睡眠呼吸暂停的肥胖青少年组具有小口咽(t=7.56,P<0.05)、大腺样体(t=8.79,P<0.05)、大扁桃体(t=10.11,P<0.05)以及大咽后淋巴结(t=9.35,P<0.05)的解剖特点，并且这些淋巴组织的大小与阻塞性睡眠呼吸暂停的严重程度有关；而人体质量指数的Z分数与这些组织的大小无相关性。同时，发生阻塞性睡眠呼吸暂停的青少年具有增大的咽旁脂肪垫(t=1.32,P>0.05)和腹部内脏脂肪(t=0.78,P>0.05)，而脂肪组织的多少与阻塞性睡眠呼吸暂停的严重程度无关。人体质量指数的Z分数对脂肪组织的多少无关。结论上气道淋巴组织增生是肥胖青少年发生阻塞性睡眠呼吸暂停的重要因素，而这些组织的增生与肥胖无关。尽管患有阻塞性睡眠呼吸暂停的肥胖青少年具有更丰富的咽旁脂肪垫和腹部内脏脂肪，但并未发现其与阻塞性睡眠呼吸暂停的严重程度及肥胖有直接关系。

关键词:淋巴组织增生|肥胖青少年|磁共振影像|阻塞性睡眠呼吸暂停综合征

Abstract:

Abstract:ObjectiveTo assess anatomical risk factors for obstructive sleep apnea syndrome (OSAS) in obese adolescents.Methods24 obese children with OSAS (BMI Zscore=2.2±0.4) and 24 without OSAS (BMI Zscore=2.1±0.3) were studied. MRI was used to perform measurement of upper airway structure and body fat composition. Multifactor regression analysis and conditional logistic regression were used for data analysis. ResultsCompared with obese adolescents without OSAS, subjects with OSAS had such characters as small oropharyngeal cavity (t=7.56, P<0.05), enlarged tonsils (t=8.79, P<0.05) and adenoid (t=10.11, P<0.05), and hypertrophied retropharyngeal lymphaden (t=9.35, P<0.05). The hypertrophy of lymphatic tissues was related with the severity of OSAS. Nevertheless, BMI Zscore did not correlate with the size of lymphoid tissues. Parapharyngeal fat pads and abdominal visceral fat of the obese children with OSAS were larger than those without OSAS (t=1.32, P>0.05) (t=0.78, P>0.05). The fat tissues did not have correlation with the severity of OSAS. BMI Zscore didn’t have correlation with fat accumulation.ConclusionsUpper airway lymphoid tissue hypertrophy is one key factor of OSAS in obese children. The lymphoid tissue isn’t associated with obesity. Although accumulation of parapharyngeal fat pads and abdominal visceral fat exists in the obese children with OSAS, the fat accumulation shows no direct correlation with OSAS or obesity.

Key words:淋巴组织增生|肥胖青少年|磁共振影像|阻塞性睡眠呼吸暂停综合征