腺样体肥大儿童睡眠呼吸障碍的研究

Study of sleep related breathing disorders in adenoidal hypertrophy children

目的 了解腺样体肥大儿童出现阻塞性睡眠呼吸障碍 (OSA)的比率、临床表现、腺样体肥大程度与多导睡眠图 (PSG)结果的相关性。方法 对 42例腺样体肥大住院患儿的临床资料、鼻咽侧位片、PSG结果进行前瞻性比较研究。结果 42例腺样体肥大患儿中 3 3例 (78.6% )并OSA ;OSA患儿呼吸暂停、晨起疲倦表现与PSG结果中最长呼吸暂停时间的相关系数r =0 .2 16 P <0 .0 5 ,白天张口呼吸的频繁程度与呼吸暂停低通气指数 (AHI)、阻塞性呼吸暂停指数 (OAI)相关性的P分别 0 .0 15、0 .0 3 3 ;鼻咽侧位片A/n值与PSG结果相关性的P为 0 .0 5 5。结论 OSA在腺样体肥大患儿中出现比率较高 (78.6% ) ;腺样体肥大患儿中睡眠呼吸暂停及晨起疲倦表现与PSG最长呼吸暂停时间呈正相关。白天张口呼吸的频繁程度对OSA的严重程度有预测作用 ;

Objective To investigate the percentage of obstructive sleep apnea(OSA) in adenoidal hypertrophy, the relationship to the chief complaint, the size of the adenoid and the result of the polysomnography (PSG). Methods We prospectively compared the clinical data, neck roentgenography, and overnight polysomnography in forty two adenoidal hypertrophy children admitted to Beijing Children′s Hospital between December 1, 2001 and February 10, 2002.Results Thirty three children (78.6 %) have OSA of all the 42 patients. The R square of correlation between the symptoms of stop breathing and tiredness in the morning and the longest duration of sleep apnea in the PSG was 0.216 with the P value of 0.026. The P values of the correlation between the frequency of daytime mouth breathing and apnea hypopnea index (AHI), obstructive apnea index (OAI) in PSG were 0.015 and 0.033 respectively. The P value of the correlation between the A/n ratio in the neck roentgenography and the results of PSG was 0.055. Conclusions OSA had high percentage(78.6 %) among the adenoidal hypertrophy children. The common symptoms of stop breathing and tiredness during the morning have positive relationship to the longest duration of sleep apnea in PSG. The frequency of daytime mouth breathing could predict the severity of OSA. The size of the adenoid and the duration of obstructive sleep apnea may have some relationship. And the A/n ratio may predict the present of OSA.