鼾症儿童多导睡眠图监测的临床意义

目的探讨诱发儿童阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的主要病因和多导睡眠图监测（PSG）参数对儿童OSAHS诊断及鉴别诊断的价值。方法对125例鼾症儿童行PSG和头颅X线侧位片检查，分析呼吸暂停低通气指数（AHI）与扁桃体及腺样体肥大、鼾声指数、最低血氧饱和度的相关性。结果125例鼾症儿童中符合儿童OSAHS诊断标准70例：扁桃体和／或腺样体肥大81例，符合儿童OSAHS诊断标准55例。随着AHI的增大，A／N、T／P及鼾声指数逐渐增大，呈现显著的正相关（r=0635、0528、0815，均P〈0．01）；而最低血氧饱和度逐渐下降，呈现显著的负相关（r=-0787，P〈0．01）。此外，随着AHI的增大，患儿出现呼吸暂停、低通气的总合平均持续时间（均在10s以上）也逐渐延长。结论扁桃体及腺样体肥大是诱发儿童OSAHS的主要病因，行PSG并对其参数进行分析，对于诊断和鉴别诊断儿童OSAHS疾病有着重要的临床意义。

Polysomnographic monitoring for snoring in children

Objective To investigate the underlying diseases inducing Obstructive Sleep Apnea-Hypopnea Syndrome （OSAHS）in snoring children with Polysomnograph （PSG） monitor. Methods One hundred and twenty five cases of children snoring were examined by PSG monitoring and lateral X-ray cephalogram. The correlation of apnea-hypopnea index （AHI） with adenoidal hypertrophy （AN ratio）, relative sizes of tonsils （TP ratio）, snoring index and the lowest oxygen saturation were analyzed. Results In 125 children snoring cases, 70 were diagnosed as OSAHS, among whom 55 had tonsil and adenoidal hypertrophy （78.57%,55/70）. TP ratio and AN ratio were positively correlated with AHI （P 〈0.01）. The lowest oxygen saturation and the snoring index were closely correlated with AHI. The aggregated average lasting period of the sleep apnea and hypoventilation in any AHI range was above 10 seconds. Conclusion Tonsil and adenoidal hypertrophy is the major cause inducing children OSAHS. The PSG monitoring is of value in diagnosis and differential diagnosis of children OSAHS.