目的：探讨阻塞性睡眠呼吸暂停低通气综合征（ OSAHS）对患者上气道咽侧壁的厚度、腮腺密度和颌下脂肪的影响。方法收集南昌大学第一附属医院2013年10月—2014年10月经多导睡眠图（ PSG ）监测确诊为OSAHS的成年男性患者52例为OSAHS组，同期选取本院行颈部CT扫描的正常成年男性32例为对照组。采用128层螺旋CT进行上气道扫描，分别测量OSAHS组清醒状态下和闭口堵鼻（ Muller）试验下及对照组清醒状态下软腭区、舌后区、会厌后区的左右咽侧壁厚度，同时测量两组清醒状态下左右腮腺密度和颌下脂肪体积。结果清醒状态下， OSAHS组软腭区、舌后区、会厌后区左右咽侧壁厚度均大于对照组（ p〈0.05）。OSAHS组清醒状态下软腭区、舌后区左右咽侧壁厚度均小于Muller试验下（p〈0.05）；OSAHS组清醒状态下与Muller试验下会厌后区左右咽侧壁厚度比较，差异无统计学意义（p〉0.05）。清醒状态下，OSAHS组左右腮腺密度低于对照组，颌下脂肪体积大于对照组（p〈0.05）。结论上气道咽侧壁厚度、颌下脂肪体积、腮腺脂肪浸润在OSAHS的发生发展中均有显著变化，对其发病机制的进一步研究有重要意义。%Objective To investigate the impact of obstructive sleep apnea hypopnea syndrome( OSAHS)on the thickness of upper airway pharyngeal wall, parotid and fatty tissue under the jaw. Methods Fifty ― two adult male patients diagnosed with OSAHS by polysomnography( PSG),and 32 normal adult males underwent neck CT scan in The First Affiliated Hospital of Nanchang University from October 2013 to October 2014 were selected as OSAHS group and control group, respectively. Patients with OSAHS ( OSAHS group both in sober state and in Muller maneuver ) and control group ( in sober state)underwent 128 ― slice multidetector row spiral CT scan of the upper airway, measuring the pharyngeal wall thickness around the retro―soft palate region postlingual region and retroglottal region. Two groups in sober state measured density of parotid and fat volume under jaw. Results In sober state,the thickness of pharyngeal wall in OSAHS group was thicker than control group in all the three regions with statistically significant difference(p〈0. 05). In sober state,the pharyngeal wall thickness around both soft palate and postlingual regions was significantly thinner than that in Muller maneuver in the OSAHS group( p〈0. 05). Between two kinds of conditions,Muller maneuver and sober state,pharyngeal wall thickness around retroglottal region in OSAHS group demonstrated no statistically significant difference ( p 〉0. 05 ) . The density of bilateral parotids of OSAHS group was lower than that of control group(p〈0. 05),and the fat volume under the jaw was larger than that of control group(p〈0. 05). Conclusion The thickness of upper airway pharyngeal wall,fatty tissue under the jaw and fatty infiltration of the parotid have great changes in the onset and development of OSAHS,which is of important significance in the further study of OSAHS's pathogenesis.
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