慢性间歇性缺氧对阻塞性睡眠呼吸暂停低通气综合征儿童听功能的影响

Influence of Chronic Intermittent Hypoxia on Hearing in Children with Obstructive Sleep Apnea Hypopnea Syndrome

目的探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)所致的慢性间歇性缺氧对儿童听功能的影响。方法对OSAHS患儿220耳进行纯音测听(pure tone audiometer,PTA)和畸变产物耳声发射(distortion product acoustic emission,DPOAE)检测,与对照组60耳比较。结果轻度OSAHS组患儿PTA平均听阈、单个频率听阈与对照组比较,差异无统计学意义(P>0.05)。中、重度OSAHS组患儿PTA的4 kHz、8 kHz听阈较对照组升高,差异有统计学意义(P<0.05),其余频率听阈、平均听阈与对照组比较,差异无统计学意义(P>0.05)。轻度OSAHS组患儿DPOAE幅值与对照组比较,差异无统计学意义(P>0.05)。中、重度OSAHS组患儿DPOAE幅值在6 kHz、8 kHz较对照组降低,差异有统计学意义(P<0.05)。轻度OSAHS组患儿高频听阈与氧减饱和度指数(ODI)、最低血氧饱和度(LSaO2)、呼吸暂停低通气指数(AHI)、平均血氧饱和度(MSaO2)、血氧饱和度<90%占整个记录时间的百分比(T90)无显著相关(P>0.05)。中、重度OSAHS组患儿高频听阈与ODI成正相关、与LSaO2成负相关,与AHI、MSaO2、T90无显著相关(P>0.05)。结论慢性间歇性缺氧可能是影响OSAHS儿童听觉功能的独立因素,血氧饱和度下降的程度和频率与OSAHS儿童的听觉功能损害密切相关。

Objective To explore the influence of chronic intermittent hypoxia on hearing in children with obstructive sleep apnea hypopnea syndrome.Method PTA and DPOAE were recorded in 220 ears of children suffering from OSAHS and 60 ears of healthy children.The results were analyzed.Results There was no statistical difference between the mild OSAHS group and the control group in PTA and single frequencies(P>0.05).There was statistical difference between the moderate and severe OSAHS group and the control group in PTA at 4 kHz and 8 kHz(P<0.05).There was no statistical difference between the mild OSAHS group and the control group in the amplitudes of DPOAE(P>0.05).There was statistical difference between the moderate and severe OSAHS group and the control group in the amplitudes of DPOAE at 6 kHz and 8 kHz(P<0.05).The high-frequency hearing loss of the moderate and severe OSAHS group was positively correlated with ODI(P<0.05)and negatively correlated with LSa O2(P<0.05),but had no significant correlation with AHI,MSaO2 and T90(P>0.05).Conclusion Chronic period hypoxia may be an independent factor influencing auditory function in childhood OSAHS.The degree and frequency of blood oxygen saturation decrease are closely related to the hearing impairment of OSAHS children.