儿童阻塞性睡眠呼吸暂停低通气综合征睡眠监测分析

目的 探讨儿童阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)呼吸事件特点.方法 对2003年5月～2006年3月我院行多导睡眠监测的326例OSAHS患者进行分析,其中儿童97例,成人229例.为方便统计学处理的可比性,根据呼吸暂停低通气指数(apnea and hypopnea index,AHI)水平,将所有成人和儿童病例分为一组(AHI 5～20 次/小时)、二组(AHI 21～40 次/小时)和三组(AHI＞40次/小时),对同等级的儿童组和成人组对照分析.指标包括儿童组发病年龄分布、儿童组与成人组在体块指数(body mass index,BMI)与AHI相关性、呼吸事件时间、动脉血氧饱和度(arterial oxygen saturation,SaO2)、最低SaO2、氧减指数以及90%以下氧减事件发生率.结果 儿童OSAHS发病年龄密集在5～6 岁;儿童BMI与AHI无明显相关性(P=0.275);儿童各组SaO2均高于成人各组;儿童二、三组最低SaO2高于成人二、三组,而平均氧减指数以及则低于成人二、三组.结论 儿童OSAHS发病高峰期在5～6 岁,AHI与BMI无明显相关性,呼吸事件持续时间短,平均呼吸暂停时间不随病情加重而延长,氧减程度轻,90%以下氧减事件发生较少.

Characteristics of polysomnography in children with obstructive sleep apnea hypopnea syndrome

OBJECTIVE To explore the polysomnography (PSG) characteristics of obstructive sleep apnea hypopnea syndrome (OSAHS) in children. METHODS A total of 326 patients with OSAHS, including 97 children and 229 adults, were monitored with PSG from May 2003 to May 2006 in our hospital. All the patients were divided into mild, moderate and severe groups according to the apnea and hypopnea index (AHI). The comparisons were made between children and adults within the same group respectively. The observed variables included age distribution in children group, the correlation coefficient between BMI and AHI, the average time of apnea and hypopnea, the average level of oxygen saturation, the level of the lowest oxygen desaturation (LSaO2), the oxygen desaturation index, and the desaturation percentage (oxygen saturation <90 %). RESULTS The age of the children with OSAHS concentrated around 5 to 6 years; There was no significant relationship between BMI and AHI for children patients (P=0.275). The average time of hypopnea was shorter for children than that for adults within each group and the average time of apnea was shorter for children within the moderate and severe groups. On average, the oxygen saturation was higher for children than that for adults within each group and the lowest oxygen desaturation (LSaO2) was higher but the oxygen desaturation index was lower for children within the moderate and severe groups. The proportion of the desaturation percentage below 90 % in children patients was less than that in adult patients within moderate andserver groups (P=0.001). CONCLUSION The children tended to contract OSAHS at the age of 5 to 6 years. There is no significant correlation between AHI and BMI for children patients. The duration of apnea and hypopnea is shorter, the level of oxygen desaturation is lower and the proportion of child patients whose desaturation percentage was below 90 % is smaller in children patients compared to those in adult patients.