目的 通过分析不同季节阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿临床及多导睡眠监测(PSG)资料,探讨季节因素对苏州地区儿童 OSAHS的影响。 方法 选取自2017年3月—2019年2月因“打鼾、张口呼吸”等症状就诊于苏州大学附属儿童医院呼吸科,行PSG检查的患儿为研究对象。根据年龄分为两组(≤6岁;＞6岁),比较两组OSAHS患儿在不同季节的诊断情况、睡眠结构、阻塞性呼吸暂停低通气指数(OAHI)、氧减指数(ODI)、最低血氧饱和度(LSaO2)等指标在不同季节的差异。 结果 1)227例OSAHS患儿夏季诊断率最低(χ2=8.964,P=0.03)。2)轻、中、重度OSAHS患儿季节诊断率比较,差异无统计学意义(P＞0.05)。3)春季OSAHS患儿非快动眼睡眠2期(NREM2)比例低于夏季、冬季(P＜0.05),春季快动眼睡眠期(REM)比例高于夏季、冬季(P＜0.05),而非快动眼睡眠3期(NREM3)比例夏季低于春季、冬季(P＜0.05)。4)春季LSaO2低于夏季(P=0.011),快动眼睡眠期呼吸暂停指数(REM-AI)高于秋冬季(P＜0.05)。5)≤6岁OSAHS患儿春季NREM2期比例低于夏季(P<0.001);夏季NREM3期比例低于春冬季(P＜0.05);春季REM期比例高于冬季(P=0.048),LSaO2(%)低于夏季(P=0.004),REM-AI高于冬季(P<0.01)。 结论 季节因素对于儿童OSAHS严重程度无明显影响,不同季节OSAHS睡眠结构及呼吸事件有所不同,主要见于≤6岁患儿。
Abstract
Objective To analyze the clinical and polysomnography (PSG) data ofchildren with obstructive sleep apnea hypopnea syndrome (OSAHS) in different seasons, and to explore the influence of seasonal factors on children with OSAHSin Suzhou area. Methods From March 2017 to February 2019, children with snoring, mouth breathing and other symptoms who visited Respiratory Medicine Department of Children's Hospital of Soochow University and had PSG examination were selected into this study. Then the participants were divided into two groups:≤6 years old and ＞6 years old. The differences in diagnosis, sleep structure, obstructive apnea hypopnea index (OAHI), oxygen desaturation index (ODI), the lowest oxygen saturation(LSAO2) among different seasons between the two groups were compared. Results 1) Among 227 OSAHS cases, the lowest OSAHS detection rate was in summer (χ2=8.964, P=0.03). 2) There was no significantly seasonal difference in diagnosis rates of children with mild, moderate and severe OSAHS (P>0.05). 3)The proportion of non-rapid movement 2 (NREM2) of OSAHS in spring was lower than in summer and winter (P＜0.05).The proportion of rapid eye movement (REM) in spring was higher than that in summer and winter (P＜0.05).The proportion of non-rapid movement 3 (NREM3) in summer was lower than that in spring and winter (P＜0.05). 4) LSaO2 in spring was lower than that in summer (P＜0.001). REM-apnea index(REM-AI) in spring was higher than that in autumn and winter (P＜0.05). 5) The proportion of NREM2 stage in OSAHS children ≤6 years old in spring was lower than that in summer (P＜0.001). The proportion of NREM3 in summer was lower than that in spring and winter (P＜0.05), and the proportion of REM in spring was higher than that in winter (P=0.048). Respiratory events and oxygen saturation analysis showed that LSaO2 (%) in spring was lower than that in summer (P=0.004). REM-AI in spring was higher than that in winter (P<0.01). Conclusions Seasonal factors have no significant effect on the severity of OSAHS in children. Sleep structure and respiratory events of OSAHS are different in seasons, such changes are mainly in children at the age of 6 years old and younger.
关键词
阻塞性睡眠呼吸暂停低通气综合征 /
儿童 /
季节 /
睡眠结构 /
多导睡眠监测
Key words
obstructive sleep apnea hypopnea syndrome /
children /
season /
sleep structure /
polysomnography
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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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