儿童睡眠呼吸暂停低通气综合征呼吸事件时间判定的研究  

The study about the correlations of apnea & hypopnea time and the decrease of arterial oxygen saturation (△SaO_2) of obstructive sleep apnea hypopnea syndrome in children

作　　者：李宏彬[1] 叶京英[1] 高莉敏[2] 王小轶[1] 尹国平[1] 张玉焕[1] 丁秀[1] 王江泳[1] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京100730 [2]北京中医药大学管理学院公共事业管理教学部,北京100029

出　　处：《中国耳鼻咽喉头颈外科》2006年第7期441-446,共6页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：北京市科学技术委员会资助项目(NO:Z0005190041531)

摘　　要：目的通过分析阻塞性睡眠呼吸暂停低通气综合征(obstructivesleepapneahypopneasyndrome,OSAHS)患儿的多导睡眠监测(polysomnogram,PSG)结果,探讨OSAHS患儿的呼吸事件(呼吸暂停/低通气)时间的判定标准。方法随机抽取107例自2004年1月至2006年5月间行多导睡眠监测后被诊断为OSAHS患儿的原始多导睡眠图,在排除了伪差后,观察每次血氧饱和度的下降值(△SaO2)及其伴随的呼吸事件时间。结果①△SaO2与呼吸暂停/低通气时间高度相关(P<0.01);②学龄前儿童与学龄期儿童在身高、体重、人体质量指数(bodymassindex,BMI)之间的差异具有显著性(P<0.01);③学龄前儿童与学龄期儿童在快动眼(rapideyemovement,REM)睡眠期及慢动眼(nonrapideyemovement,NREM)睡眠期之间的氧减指数具有显著性差异(P<0.01);④不同性别的患儿在REM期NREM期之间氧减指数也有显著性差异(P<0.01);⑤血氧饱和度下降3个百分点时(△SaO2=3%)呼吸事件的持续时间为5.4秒。结论①对儿童多导睡眠监测图的分析可为探索儿童呼吸事件判定标准提供方法;②△SaO2=3%时呼吸事件的时间与年龄有一定的相关性(r呼吸暂停=0.213,r低通气=0.225,P<0.05);③5.4秒可以作为儿童呼吸事件的判定依据,统一的儿童呼吸事件的判定标准应尽早制定。OBJECTIVE To investigate the criterion of respiration event time of obstructive sleep apnea hypopnea syndrome（OSAHS） in children by analysis polysomnogram（PSG）. METHODS The random sample of OSAHS in children 107 cases were diagnosed by PSG from Jan 2004 to May 2006,after exception false analysis, observing every decrease of arterial oxygen saturation（△SaO2） and go with respiration event time. RESULTS ① （△SaO2） was associated with increased rates of respiration event time（P〈0.01）; ②There was significantly difference between preschool and school age of height, weight and BMI （P〈0.01）; ③There was significantly difference between preschool and school age of hypoxemia index at REM stage and NREM stage（P〈0.01）; ④ Between boy and girl also has significantly difference of hypoxemia index at REM stage and NREM stage（P〈0.01）;① The time of decrease 3 percent of arterial oxygen saturation （△SaO2=3 %） is 5.4 seconds. CONCLUSION The analysis of children PSG can offer a goog method of erecting criterion of respiration event; ②There was a little correlation between the duration of △SaO2=3 %and age（rapnea= 0.213,rhypopnea=0.225,P〈0.05）;③In my opinion;the criterion of respiration event time of OSAHS in children was 5.4 seconds;the uniform criterion should be established as soon as possible.

关 键 词：儿童 阻塞性睡眠呼吸暂停低通气综合征 呼吸暂停 血氧饱和度 多导睡眠描记术 

分 类 号：R766[医药卫生—耳鼻咽喉科]