肥胖儿童睡眠呼吸暂停的高危因素及其性别差异分析

目的分析影响肥胖儿童睡眠呼吸暂停的高危因素并探讨其性别差异。方法对笔者医院收治120例肥胖儿童可能影响睡眠呼吸暂停（OSA）的因素进行单因素分析和Logistic多元回归分析。结果单因素分析显示男孩、严重打鼾、张口呼吸、晨起头痛、白天嗜睡、夜间多汗、夜间遗尿、睡眠不安、高脂血症、影像学显示上气道狭窄，在OSA和非OSA组间有统计学差异。Logistic回归分析显示，男孩发生OSA的高危因素有严重打鼾、张口呼吸、夜间多汗和影像学显示上气道狭窄；女孩发生OSA的高危因素有严重打鼾、张口呼吸、夜间遗尿和影像学显示上气道狭窄。脂代谢分析显示，中重度OSA肥胖患JLN固醇和低密度脂蛋白较轻度组明显增高。结论不同性别肥胖儿童OSA的高危因素有所不同，但严重打鼾、张口呼吸、白天嗜睡和影像学显示上气道狭窄是共同的主要危险因素，中重度OSA患儿存在较明显脂代谢紊乱。

High Risk Factors and Gender Differences Analysis in Obese Children with Obstructive Sleep Apnea.

Objective To analyse the risk factors of obstructive sleep apnea （OSA） and the gender differences in obese children. Methods Totally 120 cases of obese children treated in our hospital were included to make single factor analysis and Logistic multivariate regression analysis. Results Single factor analysis showed that boy, severe snoring and mouth breathing, morning headaches, excessive daytime sleepiness, night sweat, nocturnal enuresis, sleep uneasiness, hyperlipidemia, imaging showed upper airway stenosis had signifi- cant difference between OSA and non - OSA groups. Logistic regression analysis showed that severe snoring, mouth breathing, night sweat and imaging showed upper airway stenosis were risk factors of OSA in obese boy; while severe snoring, mouth breathing, nocturnal enure- sis and imaging showed upper airway stenosis were risk factors of OSA in obese girl. Lipid analysis showed that cholesterol and low density lipoprotein cholesterol were significantly higher in moderate or severe OSA children than those in the mild group. Conclusion This study demonstrated a gender difference in the risk factors of OSA in obese children, but severe snoring, mouth breathing, excessive daytime sleepiness and imaging showed that upper airway stenosis were the common risk factors. Moderate or severe OSA children existed obvious lipid metabolic disorders.