The Relationship Between Anatomic Measurements Of Pharynx And Other Factors In Patients With Obstructive Sleep Apnea-hypopnea Syndrome

Objective To investigate the morphosis of pharynx in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) during sleeping.And to study its relationships with apnea-hypopnea index(AHI),body mass index(BMI),breathing control,and so on.Methods 35 OSAHS patients(with an apnea-hypopnea index,AHI≥5),27 men and 8 women,were studied.And they were subdivided into two groups by AHI:mild group included 14 patients with 5＜AHI≤20,and moderate-severe group included 21 patients with AHI＞20.Polysomnography,Breathing control and CT of the upper airway during sleep periods were performed in both groups at supine position without oxygen.All parameters were compared between the two groups.Results In sleeping without Oxygen,data comparative results were as follows:1.Tongue area,width and height of soft palate,and Genioglossal(GG) width in AHI>20 group were larger than those in 5＜AHI≤20(P<＜0.05),and the former had the smaller minimum area of retropalatal region(P＜0.05).2.P0.1 showed lower in AHI＞20 than 5＜AHI≤20 group,and there were significantly statistical differences between them(P＜0.05).At the same time, Correlation analysis showed that P0.1 was negatively correlated with GG width (r=-0.574,P＜0.05) for patients with AHI＞20 group.And this relationship was only associated with AHI＞20 group.3.There were obviously statistical significance in the minimum area of RP,tongue length and tongue area between different BMI(P＜0.05).With the increasing of BMI, the measurement parameters of the soft palate width,soft palate height,soft palate area,tongue height were increasing,too.But there were not obviously statistical significance.And we found that there were significant positive correlation between AHI and BMI for obese patients(r=0.608,P＜0.001).Conclusions1.Patients with AHI＞20 have more narrowed pharyngeal cavity than 5＜AHI＜20, suggesting that there are some differences of pharyngeal morphology for differences AHI in OSAHS patients during sleeping. 2.PO.l was negatively correlated with GG width(r=-0.574,P＜0.05) for patients with AHI＞20 group.That is to say,with the increasing of AHI,the compensation activity of GG increases.But the impulse to the cerebral cortex is disappearance when GG width is at a certain extent,then the respiratory driver drops even more.3.Patients with different BMI had the differences of pharyngeal morphology and the mechanism for OSAHS in sleeping.With the increase of BMI,the severity of OSAHS is increase,too.AHI is associated with BMI.BMI can indirectly reflect on the degree of upper airway obstruction and the development of disease in OSAHS.