宜宾市6～12岁儿童阻塞性睡眠呼吸暂停低通气综合征患病情况及生活质量调查

Survey on prevalence and quality of life of OSAHS among children aged 6 to 12 years old in Yibin

目的调查宜宾市6~12岁儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患病情况,了解患病特征和OSAHS患儿生活质量,为OSAHS防治和开展健康宣教提供指导依据。方法于2018年1~6月采用分层整群抽样方法,抽取宜宾市6~12岁儿童1903例,采用Berlin问卷进行OSAHS初筛,初筛阳性儿童94例,纳入OSAHS组,1825例正常儿童纳入非OSAHS组。对初筛阳性的儿童进行多导睡眠监测(PSG)确诊,了解OSAHS患病情况,将初筛阳性的儿童根据体型分为体型正常组(51例)和超重肥胖组(43例),用睡眠呼吸障碍儿童生活质量问卷(OSA-18)量表评估两组患儿生活质量,分析不同体型患儿的PSG监测指标和生活质量的差异。结果Berlin问卷初筛阳性94例,阳性率4.94%,男性高于女性,差异有统计学意义(P<0.05),PSG确诊78例,OSAHS总体患病率4.10%。超重肥胖组呼吸暂停指数、低通气指数、呼吸暂停低通气指数、阻塞性呼吸暂停指数均高于正常体型组,而平均血氧饱和度和最低血氧饱和度均低于正常体型组,差异均有统计学意义(P<0.05)。OSAHS患儿体质指数、颈围、收缩压和舒张压均高于非OSAHS儿童(P<0.05)。超重肥胖组OSA-18总分,睡眠问题、情绪问题及日间问题3个维度高于正常体型组,差异有统计学意义(P<0.05)。结论宜宾市6~12岁儿童OSAHS患病率约4.10%,超重肥胖者PSG指标和生活质量明显差于正常体型者,应重视健康教育和行为干预。

Objective To investigate the prevalence of obstructive sleep apnea hypopnea syndrome (OSAHS) among children aged 6 to 12 years old in Yibin, as well as the characteristics and quality of life (QOL), so as to provide guideline for OSAHS prevention, treatment and health education. Methods From January to June 2018, 1903 children aged 6 to12 years old were selected randomly by stratified cluster sampling from Yibin, with OSAHS preliminary screening by Berlin questionnaire, then 94 positive children were recruited into OSAHS group and 1 825 normal children into non- OSAHS group. OSAHS group after preliminary screening was definitely diagnosed by polysomnography (PSG) and subdivided into normal group (51 cases) and overweight/obesity group (43 cases) for the assessment of quality of life by OSA-18, and the difference in PSG monitoring index and quality of life was also detected. Results There were 94 suspicious positive OSAHS children screened by Berlin questionnaire with the prevalence of 4.94%, and the prevalence in male was higher than that in female (χ 2 = 5.50, P =0.02);78 children were definitely diagnosed as OSAHS by PSG with the prevalence of 4.10%. The apnea index, hypopnea index, apnea-hypopnea index and obstructive apnea index in overweight/obesity group were higher than those in normal group, and the mean oxygen saturation and lowest oxygen saturation were lower than those of normal group, and the difference was statistically significant ( P < 0.05). The body mass index, neck circumference, systolic pressure and diastolic pressure in OSAHS children were higher than those in non-OSAHS children, and the difference was statistically significant ( P <0.05). The total OSA-18 score and 3 dimensions, including sleep, emotion and daytime in overweight/obesity group were higher than those in normal group, and the difference was statistically significant ( P <0.05). Conclusions The prevalence of OSAHS is approximately 4.10% among children aged 6 to 12 years old in the city of Yibin, and the PSG and QOL indexes of overweight/obesity children is inferior to those of normal children, which calls for health education and behavioral intervention.