【摘要】 目的:探讨腺样体肥大(AH)患儿腺样体-鼻咽腔比率(A/N)诊断阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的价值。方法:选取79例AH患儿为研究对象，依据是否合并OSAHS分为研究组(AH合并OSAHS,n=49)和对照组(普通AH,n=30)。比较两组患者一般临床特征；回顾鼻咽部计算机断层扫描(CT)检查结果并计算A/N;分析CT检查指标诊断OSAHS的价值及OSAHS病情程度与CT检查指标的相关性。结果:本组患儿中确诊合并OSAHS病例为49例，患病率为62.03%,其中，轻度16例(32.65%)、中度16例(32.65%)、重度17例(34.69%)。研究组患儿AH程度和睡眠时气道阻塞比例高于对照组(P<0.05);上气道截面积最小值低于对照组(P<0.05);A/N高于对照组(P>0.05)。上气道截面积最小值和A/N诊断AH合并OSAHS的受试者工作特征曲线下面积(AUCROC)差异有统计学意义(P<0.05),其中A/N的AUCROC及Cut-off值下的灵敏度和特异度较高(P<0.05)。随着OSAHS病情的加重，研究组患儿的上气道截面积最小值逐渐下降(P<0.05),A/N逐渐升高(P<0.05)。相关性分析显示，OSAHS病情程度与上气道截面积最小值呈负相关关系(r=-0.936,P<0.05),与A/N呈正相关关系(r=0.927,P<0.05)。结论:利用鼻咽部CT扫描测量AH患儿的A/N值，对OSAHS的诊断有一定的价值，其水平与OSAHS病情程度相关。更多还原

【Abstract】 Objective:To analyze the value of adenoid nasopharynx ratio(A/N) in the diagnosis of obstructive sleep apnea-hypopnea syndrome(OSAHS) in children with adenoid hypertrophy(AH).Methods:79 children with AH were selected as the study subjects.They were divided into the study group(AH combined with OSAHS,n=49) and the control group(ordinary AH,n=30) according to whether they were combined with OSAHS.The general clinical characteristics of the two groups were compared.The results of nasopharyngeal computed tomography(CT) were analyzed retrospectively and A/N was calculated.The values of CT indexes in the diagnosis of OSAHS and the correlations between the severity of OSAHS and CT indexes were analyzed.Results:Among the children in this group, 49 cases were diagnosed with OSAHS,and the prevalence was 62.03%.Among them, 16 cases were mild cases(32.65%),16 cases were moderate cases(32.65%),and 17 cases were severe cases(34.69%).The severity of AH and the proportion of airway obstruction during sleep of the children in the study group were higher than those in the control group(P<0.05).The minimum cross-sectional area of upper airway of the children in the study group was lower than that in the control group(P<0.05),and A/N was higher than that in the control group(P>0.05).The areas under the receiver operating characteristic curve(AUCROC) of minimum upper airway cross-sectional area and A/N in diagnosis of AH complicated with OSAHS were statistically significant(P<0.05).Among them, AUCROC,the sensitivity and specificity at cutoff value of A/N were higher.With the aggravation of OSAHS,the minimum upper airway cross-sectional area of the children in the study group gradually decreased, and A/N increased gradually, the differences were statistically significant(P<0.05).The severity of OSAHS of the children in the study group was negatively correlated with the minimum upper airway cross-sectional area(r=-0.936,P<0.05),and positively correlated with A/N(r=0.927,P<0.05).Conclusion:Application of nasopharynx CT scan to measure the A/N value of children with AH has a certain value for the diagnosis of OSAHS.Its level is related to the severity of OSAHS.更多还原