儿童阻塞性睡眠呼吸障碍患者腺样体和扁桃体增生的临床特征及其相关性研究

目的 通过对因腺样体和/或扁桃体增生导致儿童阻塞性睡眠呼吸障碍(OSDB)需要手术的病例资料分析，探讨儿童OSDB患者腺样体和扁桃体增生程度的临床特征及相关性。方法 提取前瞻性病例数据库中737例因腺样体和/或扁桃体增生导致OSDB进行了腺样体和/或扁桃体切除术患儿的临床资料。把性别、年龄、腺样体大小、扁桃体大小等设为观察指标。对数据进行统计学分析，对相关问题进行讨论。结果 在儿童OSDB患儿中：①腺样体增生程度随年龄上升呈下降趋势，扁桃体增生程度则随年龄增加呈上升趋势，差异具有统计学意义(P＜0.01)。②腺样体和扁桃体增生程度平均得分均值差异具有统计学意义(P＜0.01)，腺样体增生程度高于扁桃体增生程度；这种差异在<6岁年龄段的儿童中尤其显著。③腺样体和扁桃体增生程度与性别无关(P均>0.05)。④腺样体增生程度与年龄呈负相关(r=-0.210，P＜0.01)；扁桃体增生程度与年龄呈正相关(r=0.175，P＜0.01)；腺样体增生与扁桃体增生呈负相关(r=-0.119，P=0.001)。结论 在儿童OSDB患者中，腺样体和扁桃体的增生具有不同的趋势和特点；腺样体增生程度与年龄呈负相关，扁桃体增生程度与年龄呈正相关；总体上腺样体的增生程度高于扁桃体，腺样体的增生对儿童OSDB贡献度较扁桃体大。

Clinical characteristics and correlation of adenoid and tonsil hyperplasia in children with obstructive sleep-disordered breathing

Objective To investigate the clinical characteristics and correlation of adenoid and tonsil hyperplasia with obstructive sleep-disordered breathing (OSDB) in children by analyzing the data of patients with adenoid and/or tonsil hyperplasia requiring surgery.Methods Clinical data of 737 children who underwent adenoidectomy and/or tonsillectomy for OSDB due to adenoid and/or tonsil hyperplasia were extracted from the prospective case database. Gender, age, adenoid size and tonsil size were set as observation indexes. The data were analyzed statistically and related problems were discussed.Results ①In children with OSDB, the adenoid hyperplasia degree decreased with age, and the tonsil hyperplasia degree increased with age, the differences were statistically significant (P＜0.01). ②The average scores of adenoid and tonsil hyperplasia were significantly different (P＜0.01), and the adenoid hyperplasia degree was higher than that of tonsil hyperplasia degree. The difference was particularly striking among children younger than 6 years of age. ③The degree of adenoid and tonsil hyperplasia was not correlated with sex (all P＞0.05). ④The degree of adenoid hyperplasia was negatively correlated with age (r=-0.210, P＜0.01). The degree of tonsil hyperplasia was positively correlated with age (r=0.175, P＜0.01). Adenoid hyperplasia was negatively correlated with tonsil hyperplasia (r=-0.119, P=0.001).Conclusions Adenoid and tonsil hyperplasia have different trends and characteristics in children with OSDB. Adenoid hyperplasia degree is negatively correlated with age, tonsil hyperplasia degree is positively correlated with age. On the whole, adenoid hyperplasia is higher than tonsil hyperplasia, and the hyperplasia of adenoid contributes more to children’s OSDB than that of tonsil.