OSA-18量表评估过敏性鼻炎合并阻塞性睡眠呼吸暂停低通气综合征患儿治疗效果的临床价值

The clinical value of OSA-18 scale in evaluating the treatment effect of obstructive sleep apnea hypopnea syndrome in children with allergic rhinitis

目的探讨儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)特异性生活质量调查(OSA-18)量表评估儿童OSAHS治疗效果的临床应用价值。方法选择该院2017年10月-2019年6月收治的合并过敏性鼻炎(AR)的轻度OSAHS儿童90例,按照随机数字表法将其分为观察组和对照组,各45例。观察组采用舌下含服免疫治疗(SLIT)联合穴位注射治疗,对照组采用舌下含服免疫治疗,随访观察3个月。两组患儿在治疗前后均行多道睡眠描记术(PSG)并采用OSA-18量表对治疗效果进行评估,分析最低血氧饱和度(LSaO2)和呼吸暂停低通气指数(AHI)与OSA-18评分的相关性。结果观察组治疗后AHI明显低于治疗前及同期对照组(P<0.05),观察组治疗后LSa O2高于治疗前及同期对照组(P<0.05),对照组治疗前后AHI、LSaO2比较,差异均无统计学意义(均P>0.05);观察组治疗后身体症状、睡眠障碍、对监护人的影响及总分均低于治疗前及同期对照组,差异有统计学意义(P<0.05),对照组治疗前后OSA-18各项指标评分及总分比较,差异均无统计学意义(均P>0.05);OSA-18各项指标评分及总分与AHI均呈正相关(P<0.05),OSA-18各项指标评分及总分除对监护人的影响外,均与LSa O2呈负相关(P<0.05)。结论OSA-18评分与PSG存在相关性,OSA-18评分对合并AR的OSAHS儿童健康状况及治疗效果的评估更为全面可行,值得推广。

Objective To analyze the specific sleep quality of children with obstructive sleep apnea 18 items survey(OSA-18)on Structive sleep apnea hypopnea syndrome(OSAHS)and to evaluate the clinical application value of children’s OSAHS treatment effect.Methods From October 2017 to June 2019,90 patients with mild allergic rhinitis(AR)with OSAHS in our hospital were selected and divided into observation group and control group according to the random number table method,with 45 cases in each group.The observation group was treated with sublingual oral immunotherapy(SLIT)combined with acupoint injection,while the control group was treated with sublingual oral immunotherapy(SLIT)and was followed up for 3 months.Two groups of children underwent polysomnography(PSG)before and after treatment,and the treatment effect was evaluated using the OSA-18 scale.The correlation between AHI,LSaO2 and OSA-18 scorewere analyzed.Results The AHI in the observation group was significantly lower than that in the control group before and after treatment(P<0.05).The LSaO2 in the observation group was higher than that in the control group before and after treatment(P<0.05).No significant difference was found in the AHI and LSaO2 of the control group before and after treatment(P>0.05).Significantdifferences(P>0.05)were found;physical symptoms,sleep disorders,effects on guardians,and total scores in the observation group were lower than those in the control group before and after treatment,with significant differences(P<0.05).There was no significant difference in the scores and total scores of the OSA-18 indicators(P>0.05)in control group.The scores and total scores of the indicators of OSA-18 were positively correlated with the AHI(P<0.05)but negatively correlated with LSa O2(P<0.05)except for the influence on guardians.Conclusion OSA-18 score and PSG are correlated.OSA-18 score is more comprehensive and feasible for assessing the health status and treatment effect of OSAHS in children with AR,and it is worth to be promoted.