儿童阻塞性睡眠呼吸暂停低通气综合征听力障碍与腺样体、扁桃体病变的相关性研究

Relationship study between dysaudia and lesions of adenoid & tonsil in children with obstructive sleep apnea hypopnea syndrome

目的观察儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)听力下降患儿的腺样体、扁桃体肥大分布情况,探讨其与呼吸暂停低通气指数(AHI)的关系。方法选取行多导睡眠监测、听力学测试的OSAHS听力下降患儿81例(162耳),根据OSAHS诊疗指南分为AHI轻度、中度和重度三组,采用鼻咽部腺样体X线、鼻内窥镜检查测定腺样体及扁桃体大小,分析腺样体、扁桃体与AHI的关系。结果 AHI三组的腺样体(Ⅰ～Ⅲ级)分布:轻度组分别为50.00%、36.36%、13.64%;中度组分别为18.75%、43.75%、37.50%;重度组分别为18.52%、14.81%、66.67%;腺样体大小与AHI呈正相关(r=0.40,P<0.05)。AHI三组的扁桃体(Ⅰ～Ⅲ度)分布:轻度组分别为50.00%、22.73%、27.27%;中度组分别为31.25%、40.63%、28.13%;重度组分别为18.52%、44.44%、37.04%。扁桃体大小与AHI呈弱相关,但差异无统计学意义(r=0.20,P>0.05)。结论 OSAHS听力下降患儿与腺样体肥大疾病之间具有中度的相关性,与扁桃体肥大之间相关性不明显。

Objective To investigate the correlation between adenoid and tonsil of childhood obstructive sleep apnea hypopnea syndrome （OSAHS） patients with dysaudia. Methods Eighty-one （162 ears） OSAHS cases with dysaudia who had undergone polysomnography and audiology test were assigned to apnea hypopnea index mild group, moderate group and severe group. Using pars nasalis pharyngis adenoid X-line test and nasal endoscope to evaluate the adenoid and tonsil size. The relationship of adenoid and tonsil size and AHI was analyzed through spearman correlation. Results The distribution of adenoidal hypertrophy （ Ⅰ-Ⅲ ） in AHI groups were as follows： mild group 50.00% ,36.36%, 13.64% ;moderate group 18.75% ,43.75% ,37.50% ;severe group 18.52%, 14.81% ,66.67%. Adenoidal hypertrophy was positively related to A HI （r=0.40,P〈0.05）. The distribution of tonsil hypertrophy（ Ⅰ-Ⅲ ） in AHI groups were as follows： mild group 50.00%, 22.73% ,27.27% ;moderate group 31.25%,40.63% ,28.13%;severe group 18.52% ,44.44%,37.04% ;tonsil hypertrophy was weak related to AHI with no statistical significance （r=0.20,P〉0.05）. Conclusions OSAHS with dysaudia was obviously related to adenoidal hypertrophy but was weakly related to tonsil hypertrophy.