阻塞性睡眠呼吸暂停低通气综合征102例患儿睡眠结构分析

目的 探讨102例阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿睡眠结构改变.方法 选择因腺样体、扁桃体肥大行呼吸睡眠监测住院手术患儿102例,采用Alice-5睡眠监测仪监测其夜间睡眠情况,采用呼吸暂停低通气指数(AHI)、阻塞性呼吸暂停指数(OAI)、最低动脉血氧饱和度(LSaO2)、微觉醒指数,及睡眠Ⅰ期、Ⅱ期、Ⅲ期、Ⅳ期时长,快动眼睡眠期时长及慢波睡眠时长等参数进行分析.结果 伴有腺样体、扁桃体肥大的OSAHS患儿多数存在气道阻塞,AHI与微觉醒指数、S1、慢波睡眠及LSaO2有关(R 分别为0.37,0.26、-0.22、-0.41),差异有统计学意义(P ＜0.05)；OAI与微觉醒指数、LSaO2有关(R分别为0.29、-0.26),差异有统计学意义(P＜0.05).但AHI、OAI及LSaO2都与快动眼睡眠期无相关(P＞0.05).结论 伴有腺样体、扁桃体肥大的OSAHS患儿多数存在气道阻塞.患儿生长发育及脑发育阻滞来源于阻塞性呼吸暂停发生次数的增多.对腺样体、扁桃体肥大患儿应采取积极治疗,尽早纠正低血氧浓度,改善睡眠质量,恢复患儿身心健康.

Sleep structure of 102 cases of obstructive sleep apnea hypopnea syndrome children

Objective To explore the changes of sleep structure in 102 children of obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods All 102 cases with adenoid and tonsils hypertrophy undertook monitoring nocturnal sleep and breathing by Alice-5 monitor of sleep were selected. The apnea hypopnea index（ AHI）, obstruct apnea index（OAI） , lowest oxygen saturation（ LSaO2 ） , arousal index, the length of sleep stage I , II , III, IV, and slow wave sleep（SWS） length, rapid eye movement（REM） length were detected and analyzed. Results The patients with OSAHS accompanied by adenoidal and tonsils hypertrophy showed airway obstruction. The AHI was significantly related to arousal index, S1, SWS and LSaO2 （R = 0.37, 0.26, - 0. 22, - 0.41, respectively） （ all P 〈 0.05）. The OAI was significantly related to arousal index and LSaO2 （ R = 0.29, - 0.26） （ all P 〈 0.05 ）. Conclusions The block in growth of children with OSAHS and development of their brain is derived from the less of the oxygen concentration, and not just because of the decrease of REM period. The correction of low oxygen concentration, improvement of the sleep quality should be achieved for the recovery of children with OSAHS.