儿童阻塞性睡眠呼吸暂停低通气综合征的诊断方法与标准

Diagnostic methods and criteria of obstructive sleep apnea hypopnea syndrome in children

阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)作为儿童期常见疾病,严重危害儿童生长发育,是当前临床多学科研究之热点。儿童OSAHS在发病机制、临床表现等方面的多样性与特异性使其临床诊断变得复杂,目前对该疾病的诊断仍存在不少争议。本综述探讨了OSAHS“金标准”多导睡眠监测、脉搏血氧监测、纤维鼻咽镜以及鼻咽侧位片、CT、MRI等影像学检查在内的多种临床常用的儿童OSAHS诊断方法,并强调《中国儿童阻塞性睡眠呼吸暂停诊断与治疗指南(2020)》中以阻塞性呼吸暂停低通气指数(obstructive apnea hypopnea index,OAHI)≥1次/h作为儿童OSAHS的诊断界值及病史和查体的重要性,以期为OSAHS患儿的临床诊治提供帮助。

Obstructive sleep apnea hypopnea syndrome(OSAHS),which is a common childhood disease,is a trend⁃ing topic in clinical multidisciplinary research due to its detriment to the growth and development of children.Due to the wide variety and specificity of pathogenesis and clinical manifestations,the clinical diagnosis of OSAHS is sophisti⁃cated and difficult and remains controversial in the field.This review summarizes the common diagnostic methods in OSAHS for children,including polysomnography,which is known as the current“gold standard”,pulse oximetry,fiber⁃optic nasopharyngoscopy,nasopharyngeal lateral X⁃ray,CT,and magnetic resonance imaging(MRI).Furthermore,it em⁃phasizes the new diagnostic critical value from Chinese guidelines for the diagnosis and treatment of obstructive sleep apnea in children(2020)for children with OSAHS released by China in 2020:the obstructive apnea hypopnea index(OAHI)is≥1 time/h;it also emphasizes the importance of history and physical examination to contribute to clinical di⁃agnosis and treatment for children with OSAHS.