STOP-BANG问卷、下颌骨宽度及上气道不同层面CT测量对OSAHS患者严重性评估研究

STOP-BANG questionnaire, mandibular width and upper airway CT measurements at different levels to evaluate the severity of OSAHS patients

摘要:

目的 探讨STOP-BANG问卷（STOP-BANG questionnaire, SBQ）、下颌骨宽度及上气道不同层面CT测量对阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome , OSAHS)筛查的临床价值。方法 选择2020年9月—2021年5月在柳州市人民医院耳鼻咽喉头颈外科就诊的疑似OSAHS患者60例，进行SBQ、下颌骨宽度测量、上气道多平面CT测量，同期多导睡眠图（polysomnograph, PSG）监测。结果 根据睡眠呼吸暂停低通气指数（Sleep apnea hypopnea index, AHI）将研究对象分为3组：非OSAHS组、轻中度组、重度组；3组间性别、年龄无统计学差异；3组间SBQ、下颌骨宽度、软腭冠矢状径等比较，有统计学意义（P＜0.05）；重度OSAHS组SBQ分数明显高于轻中度及非OSAHS组（P＜0.05），Logistic回归分析发现SBQ分数、下颌骨宽度为OSAHS独立危险因素，下颌骨宽度联合SBQ诊断与单一SBQ作为诊断指标相比，可提高OSAHS初步筛查的灵敏度。结论 SBQ、下颌骨宽度、软腭后区冠矢状径、悬雍垂及舌后冠状径均与OSAHS 患者病情严重程度密切相关；SBQ联合下颌骨宽度测量有助于OSAHS初筛，适合于门诊和手术病人OSAHS风险筛查。

Abstract:

Objective To explore the clinical value of STOP-BANG questionnaire (SBQ), mandibular width and CT measurements at different levels of upper airway for obstructive sleep apnea hypopnea syndrome (OSAHS) screening. Methods 60 patients with suspected OSAHS were selected from the Department of Otorhinolaryngology, head and neck surgery, Liuzhou people's Hospital from September 2020 to May 2021; And SBQ, mandibular width, upper airway CT and PSG were performed. Results The subjects were divided into three groups according to sleep apnea hypopnea index (AHI): Non-OSAHS group , mild to moderate group, severe group. There was no significant difference in gender and age among the three groups; There were significant differences in SBQ, mandibular width, coronal and sagittal diameter of soft palate, coronal diameter of uvula and posterior among the three groups (P < 0.05); The SBQ score of the severe OSAHS group was significantly higher than that of the mild-moderate and non-OSAHS groups (P<0.05). Logistic regression analysis found that SBQ and mandible width were independent risk factors for OSAHS. Compared with a single SBQ as a diagnostic index, mandibular width combined with SBQ diagnosis can improve the sensitivity of OSAHS preliminary screening. Conclusion SBQ, mandibular width, sagittal diameter of the soft palate, uvula, and posterior coronal diameter are all closely related to the severity of OSAHS patients. SBQ combined with mandibular width measurement is helpful for initial OSAHS screening and is suitable for OSAHS risk screening for outpatients and surgical patients.