目的评估特异性生活质量调查(disease specific quality of life for children with obstructive sleep apnea 18 items survey,OSA-18)量表及简体中文版儿童睡眠问卷(pediatric sleep questionnair,PSQ)在学龄前打鼾儿童中筛查阻塞性...目的评估特异性生活质量调查(disease specific quality of life for children with obstructive sleep apnea 18 items survey,OSA-18)量表及简体中文版儿童睡眠问卷(pediatric sleep questionnair,PSQ)在学龄前打鼾儿童中筛查阻塞性睡眠呼吸暂停(OSA)中的临床实用价值。方法横断面研究选取141例患者,有打鼾伴张口呼吸问题并在南京市妇幼保健院进行了鼻咽部侧位片和整夜便携式睡眠监测(portable monitoring,PM),根据腺样体大小(A/N比值)及阻塞性呼吸暂停低通气指数(OAHI)、最低血氧饱和度(lowest oxygen saturation,LSaO_(2))将患者进行分组。由患儿家长填写OSA-18量表及PSQ。比较不同分组患儿的OSA-18量表及PSQ各个维度评分及总分,分析PM和A/N比值与OSA-18及PSQ评分的相关性,并通过受试者工作特征(ROC)曲线确定最佳临界点。结果OSA组及低氧血症组OSA-18总分及各维度评分均高于非OSA组及非低氧血症组,OSA组及低氧血症组PSQ除嗜睡及其他维度,其余各维度评分及总分均高于非OSA组及低氧血症组;腺样体病理性肥大组OSA-18除身体症状及日间功能维度,其余各维度评分及总分均高于腺样体非病理性肥大组,PSQ总分及呼吸评分高于腺样体非病理性肥大组,以上差异均有统计学意义(P<0.05)。A/N比值与OSA-18除日间功能外其他各维度及总分呈显著正相关,与PSQ总分、呼吸评分呈显著正相关(P<0.05);OAHI与OSA-18总分及各维度呈显著正相关,与PSQ除其他外各维度及总分呈显著正相关(P<0.05);LSaO_(2)与OSA-18总分及各维度评分呈显著负相关,与PSQ总分、呼吸、行为维度呈显著负相关(P<0.05)。PSQ总分评价是否是OSA及是否存在低氧血症的最佳临界点均为6.5分,OSA-18总分评价是否是OSA及是否存在低氧血症的最佳临界点均为46.5分。结论OSA-18量表及PSQ可作为筛查学龄前儿童OSA、评估缺氧程度及推测腺样体肥大程度的可靠辅助检查。展开更多
The effects of illness and treatment of diabetes mellitus extend beyond medica l outcomes. We therefore evaluated health-related quality of life (HRQOL) in ch ildren (aged 8-12 years) and adolescents (aged 13-16 years...The effects of illness and treatment of diabetes mellitus extend beyond medica l outcomes. We therefore evaluated health-related quality of life (HRQOL) in ch ildren (aged 8-12 years) and adolescents (aged 13-16 years) with type 1 diabet es to compare their results with healthy peers and to identify HRQOL determinant s. A total of 68 children and adolescents from a tertiary care clinic which spec ialises in the management of diabetes, completed the generic KINDL-R questionna ire. This instrument for children and adolescents has six dimensions and an addi tional module assessing condition-related HRQOL. Overall, the HRQOL was not dif ferent between patients with type 1 diabetes and healthy controls. In some areas , children and adolescents with diabetes reported a better HRQOL compared to hea lthy peers: adolescents reported better psychological wellbeing ( P < 0.05) and children higher levels of well-being in the school domain ( P < 0.05). In gener al, children reported a better HRQOL ( P < 0.05) than adolescents with type 1 di abetes confirming age-related differences in HRQOL in the general popu lation. Lower HbA1c ( < 8%) and intensified insulin therapy ( > 3 injections/ day) were associated with a better HRQOL in different domains ( P < 0.05). The s ubscale “chronic illness”showed a better HRQOL ( P < 0.001) in children and ad olescents with diabetes compared to age-matched controls with other chronic con ditions. Conclusion:Children and adolescents from a paediatric department specia lising in diabetes management report good health-related quality of life. Young er age, good metabolic control and intensified insulin therapy are associated wi th a better health-related quality of life. Dimensions of health-related quali ty of life appear to play different roles at different ages, emphasising the imp ortance of the multidimensional health-related quality of life concept and the value of age-appropriate self-reports.展开更多
文摘目的评估特异性生活质量调查(disease specific quality of life for children with obstructive sleep apnea 18 items survey,OSA-18)量表及简体中文版儿童睡眠问卷(pediatric sleep questionnair,PSQ)在学龄前打鼾儿童中筛查阻塞性睡眠呼吸暂停(OSA)中的临床实用价值。方法横断面研究选取141例患者,有打鼾伴张口呼吸问题并在南京市妇幼保健院进行了鼻咽部侧位片和整夜便携式睡眠监测(portable monitoring,PM),根据腺样体大小(A/N比值)及阻塞性呼吸暂停低通气指数(OAHI)、最低血氧饱和度(lowest oxygen saturation,LSaO_(2))将患者进行分组。由患儿家长填写OSA-18量表及PSQ。比较不同分组患儿的OSA-18量表及PSQ各个维度评分及总分,分析PM和A/N比值与OSA-18及PSQ评分的相关性,并通过受试者工作特征(ROC)曲线确定最佳临界点。结果OSA组及低氧血症组OSA-18总分及各维度评分均高于非OSA组及非低氧血症组,OSA组及低氧血症组PSQ除嗜睡及其他维度,其余各维度评分及总分均高于非OSA组及低氧血症组;腺样体病理性肥大组OSA-18除身体症状及日间功能维度,其余各维度评分及总分均高于腺样体非病理性肥大组,PSQ总分及呼吸评分高于腺样体非病理性肥大组,以上差异均有统计学意义(P<0.05)。A/N比值与OSA-18除日间功能外其他各维度及总分呈显著正相关,与PSQ总分、呼吸评分呈显著正相关(P<0.05);OAHI与OSA-18总分及各维度呈显著正相关,与PSQ除其他外各维度及总分呈显著正相关(P<0.05);LSaO_(2)与OSA-18总分及各维度评分呈显著负相关,与PSQ总分、呼吸、行为维度呈显著负相关(P<0.05)。PSQ总分评价是否是OSA及是否存在低氧血症的最佳临界点均为6.5分,OSA-18总分评价是否是OSA及是否存在低氧血症的最佳临界点均为46.5分。结论OSA-18量表及PSQ可作为筛查学龄前儿童OSA、评估缺氧程度及推测腺样体肥大程度的可靠辅助检查。
文摘The effects of illness and treatment of diabetes mellitus extend beyond medica l outcomes. We therefore evaluated health-related quality of life (HRQOL) in ch ildren (aged 8-12 years) and adolescents (aged 13-16 years) with type 1 diabet es to compare their results with healthy peers and to identify HRQOL determinant s. A total of 68 children and adolescents from a tertiary care clinic which spec ialises in the management of diabetes, completed the generic KINDL-R questionna ire. This instrument for children and adolescents has six dimensions and an addi tional module assessing condition-related HRQOL. Overall, the HRQOL was not dif ferent between patients with type 1 diabetes and healthy controls. In some areas , children and adolescents with diabetes reported a better HRQOL compared to hea lthy peers: adolescents reported better psychological wellbeing ( P < 0.05) and children higher levels of well-being in the school domain ( P < 0.05). In gener al, children reported a better HRQOL ( P < 0.05) than adolescents with type 1 di abetes confirming age-related differences in HRQOL in the general popu lation. Lower HbA1c ( < 8%) and intensified insulin therapy ( > 3 injections/ day) were associated with a better HRQOL in different domains ( P < 0.05). The s ubscale “chronic illness”showed a better HRQOL ( P < 0.001) in children and ad olescents with diabetes compared to age-matched controls with other chronic con ditions. Conclusion:Children and adolescents from a paediatric department specia lising in diabetes management report good health-related quality of life. Young er age, good metabolic control and intensified insulin therapy are associated wi th a better health-related quality of life. Dimensions of health-related quali ty of life appear to play different roles at different ages, emphasising the imp ortance of the multidimensional health-related quality of life concept and the value of age-appropriate self-reports.
