儿童睡眠呼吸暂停低通气综合征与单纯性肥胖的相关性研究

Study on the relationship between sleep apnea syndrome and simple obesity in children

目的研究单纯性肥胖对儿童阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea/hypopnea syndrome,OSAHS)的影响,探讨身高别体质量指数与OSAHS参数的相关性。方法收集单纯性肥胖合并OSAHS患儿(OSAHS组)68例及同期来院体检的性别、年龄、体质量相匹配的健康儿童(对照组)70例,行多导睡眠监测(polysomnogram,PSG),测量身高、体质量,计算身高别体质量指数(身高别体质量指数=(体质量-同性别同身高体质量值的中位数)/同性别同身高体质量值的中位数×100%。按身高别体质量指数将OSAHS组分为轻度肥胖、中度肥胖、重度肥胖3组,记录并分析3组的平均血氧饱和度(mean oxygen saturation,MSaO_2)、最低血氧饱和度(lowest oxygen saturation,LSaO_2)、≥3%的氧减指数(oxygen desaturation index,ODI)和SaO_2≤90%的时间、身高别体质量指数;记录并分析OSAHS组与对照组PSG数据。结果 OSAHS组呼吸暂停低通气指数(apneahypopneaindex,AHI)、ODI明显高于对照组,LSaO_2明显低于对照组,差异有统计学意义(P<0.05)。重度肥胖的OSAHS患者AHI高于轻度肥胖和中度肥胖,差异有统计学意义(P<0.05);中度肥胖和重度肥胖ODI高于轻度亚组,重度肥胖又高于中度肥胖,差异有统计学意义(P<0.05);中度肥胖和重度肥胖MSaO_2高于轻度肥胖,LSaO_2低于轻度肥胖,差异有统计学意义(P<0.05)。身高别体质量指数与AHI呈正相关。结论肥胖是导致儿童OSAHS发病的重要危险因素之一,肥胖程度与睡眠呼吸障碍的严重程度相关。

Objective To investigate the sleep symptoms and polysomnographic patterns of obstructive sleep apnea in obese children and to explore the relationship between the index of weight for height and obstructive sleepapnea / hypopnea syndrome（ OSAHS） parameters. Methods Sixty-eight simple obese children（ age 2- 12 years old） with OSAHS and the same period to hospital physical examination of seventy healthy children were enrolled in this study. Polysomnography（ PSG） was done for the diagnosis of obstructive sleep apnea and every child was monitored with PSG. According to the weight for height index of the OSAHS,groups were divided into mild,moderate and severe obesity group. The mean oxygen saturation（ MSaO_2）,the lowest oxygen saturation（LSaO_2）,more than 3% of the oxygendesaturation index（ ODI）,SaO_2 less than or equal to 90% and the weight for height index were recorded.PSG data of OSAHS group and control group were recorded and analyzed. Results The apneahypopneaindex（ AHI） and ODI of patients in group OSAHS were significantly higher than those in control group. LSaO_2 was significantly lower than the control group,the difference was statistically significant（ P〈0. 05）. AHI of severe OSAHS patients was higher than that of mild and moderate（ P〈0. 05）,and there was no statistically significant difference between mild-to-moderate group（ P〈0. 05）.The ODI of moderate and severe subgroups were higher than those in mild group（ P〈0. 05）,the ODI of severe subgroups were higher than those in moderate subgroups（ P〈0. 05）. In mild subgroups,moderate and severe subgroup,MSaO_2 was higher and LSaO_2 was lower than those in mild group（ P〈0. 05）.Conclusion Obese children have a higher risk for OSAHS,and the severity of obesity was positively related to the severity of OSAHS.