不同年龄段睡眠呼吸暂停低通气患儿呼吸暂停的特点

Prevalence of central sleep apnea in different age groups of children with sleep apnea-hypopnea

目的探讨不同年龄段睡眠呼吸暂停低通气（SAH）患儿呼吸暂停的特点。方法选择2001年1月至2011年12月在广州医学院第一附属医院睡眠中心行多导睡眠监测（PSG）检查并确诊为睡眠呼吸疾病的患儿431例（年龄1-13岁），对其PSG资料进行回顾性分析。按照儿童发育情况将研究对象分为3个年龄组：幼儿组（1-〈3岁）、学龄前组（3-〈6岁）、学龄组（6-〈13岁），比较不同年龄组的SAH患儿的睡眠呼吸暂停类型及睡眠结构并探讨不同年龄组患儿呼吸暂停的特点。结果SAH患儿年龄与中枢性呼吸暂停指数呈负相关（r=-0．322，P〈0．01），与阻塞性呼吸暂停指数无明显相关（P〉0．05）。幼儿组、学龄前组、学龄组呼吸暂停低通气指数相似，其中位数分别为4．45、3．80、3．90次／h；但中枢性呼吸暂停指数中位数分别为2．35、1．50和0．90次／h，组间差异均有统计学意义（均P〈0．01）。睡眠结构在不同年龄组间的差异均无统计学意义（均P〉0．05）。结论SAH患儿呼吸暂停的类型与年龄可能存在一定关系。年龄越小，合并中枢性睡眠呼吸暂停的比率也越高。

Objective To explore the prevalence of central sleep apnea in different age groups of children with sleep apnea-hypopnea （SAH）. Methods A total of 431 children with SAH diagnosed by overnight polysomnography at our Sleep Center were retrospectively studied. They were divided into 3 groups based on their ages ： toddler group （ 1 - 〈 3 years old）, preschool group （3 - 〈 6 years old） and school group （6- 〈 13 years old）. The relationship between age and different types of apnea-hyponea index （AHI） was analyzed. And the prevalence of central sleep apnea and sleep structure were compared between the groups. Results A negative correlation existed between age and central sleep apnea index （r = -0. 322, P 〈 0. 01 ）. However, there was no correlation between age and obstructive apnea index （P 〉 0. 05 ）. AHI was similar in different age groups, but the medians of central sleep apnea index for toddler, preschool and school groups were 2. 35, 1.50 and 0. 90 events/h respectively （ all P 〈0. 01 ）. Sleep structure was similar between the groups （ P 〉 0. 05 ）. Conclusions Central sleep apnea is common in children with sleep disordered breathing. The younger their ages, a higher prevalence of central sleep apnea.