觉醒在儿童阻塞性睡眠呼吸暂停低通气综合征中的变化与意义

目的：探讨觉醒在儿童阻塞性睡眠呼吸暂停低通气综合征（OSAHS）中的变化与意义。方法：采用32导PSG监测仪，Polysmith睡眠分析软件，按国际通用标准导联连接方法，对48例睡眠呼吸障碍儿童进行整夜监测。按国际通用标准，对比分析OSAHS患儿（OSAHS组）与单纯打鼾儿童（单纯打鼾组）的觉醒变化。结果：OSAHS组的学龄前亚组和学龄期亚组非快速眼动期（NREM）1、2、3期加4期和快速眼动期（REM）几项指标，分别与单纯打鼾组的学龄前亚组和学龄期亚组比较，差异均无统计学意义（均P〉0．05）；而伴AHI觉醒指数（ArI）、伴腿动（LM）的ArI和总ArI指数OSAHS组的学龄前亚组均明显高于单纯打鼾组的学龄前亚组（均P〈0．05）；而伴鼾声ArI、自发性ArI分别与单纯打鼾组的学龄前亚组和学龄期亚组比较，差异均无统计学意义（均P〉O．05）。结论：OSAHS组患儿的睡眠为不安定睡眠，这种睡眠虽未造成睡眠结构的改变，但引起伴AHI的ArI、伴LM的ArI与总ArI数量的增加。

Arousal response in child patients in obstructive sleep apnea

OBJECTIVE: To analyze arousal response of Polysomnography (PSG) in children with obstructive sleep apnea-hypopnea syndrome (OSAHS). METHOD: Fourty-eight children with sleep disorder were studied with 32 guide Polysomnography and analyzed by Polysmith. Sleep structure and arousals of preschool-aged and school-aged children with OSAHS were compared with those of primary snore patients. RESULT: The mean value of AHI of preschool aged children with OSAHS was (10.6+/-8.9) h, of AI was (4.0+/-7.1) h, of HI was (6.6+/-4.6) h; The sleep structure between OSAHS group and primary snore group was not significant (P > 0.05). The mean value of ArI with AHI was (8.2+/-5.9) h, of ArI with LM was (19.6+/-5.8) h, whole ArI was 49.3+/-20.4 in preschool-aged children with OSAHS; The mean value of ArI with AHI was (7.6+/-6.3) h, of ArI with LM was (14.3+/-7.6) h, whole ArI was 49.9+/-14.9 in school-aged children with OSAHS. Those of OSAHS children were higher than that of primary snore patients (P < 0.05). CONCLUSION: Althought OSAHS in children is characterized by a restless sleep, the structure is prefect and mildly affected by OSAHS. The ArI with AHI, with LM and the whole ArI in OSAHS children is higher than those of primary snore patients.