目的 分析学龄前期及学龄期阻塞性睡眠呼吸暂停低通气综合征(OSAHS)儿童的临床及睡眠结构特点。方法 纳入2016年12月-2019年11月于苏州大学附属儿童医院呼吸科就诊,经多导睡眠监测诊断为OSAHS的123例患儿为研究对象,选择同期诊断为鼾症(PS)的313例患儿为对照组,根据年龄将两组患儿分为学龄前期组及学龄期组,收集临床资料及多导睡眠监测(PSG)结果。结果 学龄前期及学龄期OSAHS患儿夜间及日间症状均较对照组显著(P<0.05)。学龄前OSAHS患儿快动眼睡眠期(REM)比例高于对照组(Z=2.467,P＜0.05);学龄期OSAHS患儿总睡眠时间(TST)及睡眠效率低于学龄前OSHAS患儿(t=2.518,Z＝1.527),NREM 2期比例升高(t＝4.080),NREM 3期比例下降(Z＝1.832),氧减指数(ODI)升高(Z=1.653,P<0.05)。呼吸暂停低通气指数(AHI)与学龄前期患儿NREM 1期睡眠比例呈正相关(r=0.217),与REM期比例呈负相关(r=-0.220),体重指数(BMI)与学龄期OSAHS患儿NREM 3期比例呈负相关(r=-0.429,P<0.05)。结论 OSAHS患儿临床表现与鼾症患儿不同,且不同年龄症状有所差异;学龄期OSAHS患儿睡眠结构改变较学龄前期患儿明显;学龄前期、学龄期OSAHS患儿睡眠结构改变分别与AHI、BMI有关。
Abstract
Objective To analyze the clinical features and sleep structure characteristics of obstructive sleep apnea-hypopnea syndrome (OSAHS) in preschool-age and school-age children, in order to provide evidence for sleep assessment and interventions of children. Methods A total of 123 children diagnosed with OSAHS through polysomnography(PSG) from December 2016 to November 2019 in the Department of Respiratory of Children's Hospital of Soochow University were enrolled in this study.Meanwhile, 313 children diagnosed with primary snoring(PS) during the same period were selected into the control group.According to their ages, children were divided into preschool age group and school age group.Clinical data and PSG results were collected. Results The night and day symptoms of OSAHS preschool-age and school-age children were more significant than those in the control group (P<0.05).The proportion of rapid eye movement (REM) stage in preschool children with OSAHS was significantly higher than that in control group (Z=2.467,P＜0.05).The total sleep time (TST) and sleep efficiency of school-age children with OSAHS were lower than those of preschool children with OSHAS (t=2.518, Z=1.527, P<0.05).The proportion of non-rapid eye movement 2(NREM 2) stage in school-age OSAHS children was higher than that in the control group, while the proportion of stage NREM 3 was lower in school-age OSAHS children (t=4.080, Z=1.832, P<0.05), and oxygen desaturation index(ODI) increased(Z=1.653, P<0.05).Apnea-hypopnea index (AHI) was positively correlated with the proportion of NREM 1 stage sleep in preschool children (r=0.217), and negatively correlated with the proportion of REM stage (r=-0.220).Body mass index (BMI) was negatively related to the proportion of NREM3 stage in school-age children (r=-0.429, P<0.05). Conclusions The clinical manifestations of children with OSAHS are different from those of PS children, and vary by age.The changes of sleep structure in school-age OSAHS children are more obvious than those in pre-school children.The changes of sleep structure in preschool-age and school-age OSAHS children are related to AHI and BMI, respectively.
关键词
阻塞性睡眠呼吸暂停低通气综合征 /
儿童 /
临床特点 /
睡眠结构
Key words
obstructive sleep apnea hypopnea syndrome /
children /
clinical features /
sleep structure
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基金
国家自然科学基金(81573167);江苏省重点科技社会发展项目(BE2016676;BE2017657)
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