摘要
目的:探讨不同头部X线测量方法与儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)严重程度的关系,进一步评价头部X线测量在儿童OSAHS诊断筛查中的应用价值。方法:对61名患儿行PSG及包括颈段气管的鼻咽侧位X线摄片检查。在鼻咽侧位片上测量腺样体的厚度、直接测量法测量腺样体-鼻咽腔比率、邹明舜法测量腺样体-鼻咽腔比率、最窄上咽气道间隙(PAS)、最窄上咽气道间隙-气管直径比值(PAS/TD),并分析它们与PSG值的相关性及预测儿童OSAHS严重程度的意义。结果:头部X线测量各指标均与AHI、AI有相关性(均P<0.01)。Stepwise逐步回归法分析,入选回归方程的变量只有PAS/TD。用受试者工作特征曲线(ROC曲线)进行分析,PAS/TD用于判断儿童OSAHS的严重程度有统计学意义(P<0.01)。判断儿童轻度与中重度OSAHS的最佳临界值为0.658,此时敏感度为81.8%,特异度为76.5%。头部X线测量各指标与最低血氧饱和度(LSaO2)无相关性(P>0.01)。结论:PAS/TD是临床上进行儿童中重度OSAHS筛查的有用指标,但不能预测患儿LSaO2的严重程度。
Objective：To elucidate the relationship between different cephalometric measurements and the severity of childhood OSAHS, then analyze the value of cephalometric measurements in predicting the severity of OSAHS in children. Method：Sixty-one patients received PSG examination and standard lateral neck roentgenography including cervical trachea. Cephalometric measurements include adenoid size, adenoidal-nasopharyngeal ratio, narrowest posterior airway space of nasopharynx, ratio of the narrowest posterior airway space of nasopharynx and trachea diameter. Statistical analysis was made to study the relationship between the data of Cephalometric measurements and PSG. Result： Cephalometric measurements were all associated with AHI and AI（ P〈0.01）. Only PAS/TD variable was entered in the stepwise linear regression equation. ROC curve analysis revealed that the optimal probability cut-off in predicting moderate and severe OSA using PAS/TD ratio was 0. 658, with the area under the curve being 0. 799. The corresponding sensitivity and specificity were 81. 8% and 76. 5% respectively. There was no correlation between cephalometric measurements and LSaO2 （ P 〉 0. 01）. Conclusion： PAS/TD is useful and simple in predicting the severity of OSAHS in children, but no use in predicting the severity of arterial oxygen saturation.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2007年第8期350-352,355,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
