探讨脉搏传导时间技术诊断疑似儿童阻塞性睡眠呼吸暂停低通气综合征的应用价值  

Application of pulse transit time in children with suspected obstructive sleep apnea hypopnea syndrome

作　　者：钟建文[1] 刘大波[1] 黄振云[1] 周丽枫[1] 陈倩[1] 谭宗瑜[1] 

机构地区：[1]广州市儿童医院耳鼻喉科,广州510120

出　　处：《中国循证儿科杂志》2007年第2期126-131,共6页Chinese Journal of Evidence Based Pediatrics

摘　　要：目的介绍脉搏传导时间（PTT）技术的原理和使用方法，提高对PTT技术的认识，探讨其在诊断儿童阻塞性睡眠呼吸暂停低通气综合征（OSAHS）中的应用。方法对高度怀疑OSAHS的儿童进行整夜的PTT监测，连接鼻导管、热敏电阻检测口和鼻气流的变化来判断呼吸暂停及低通气事件，并根据PTT的变化趋势结合口、鼻气流的变化来区分阻塞性和中枢性呼吸事件，心电极、血氧探头共同检测PTT和血氧，体位监测器检测睡眠时体位的变化，记录数据并用SPSS11．0软件分析。结果125例疑似OSAHS儿童，其中男85例，女40例，年龄2～12岁，平均年龄5．8岁，全部顺利通过PTT监测，无一例半途中止，患儿接受程度高。PTT监测结果显示，最长阻塞性呼吸暂停时间（MOAT）为（32．02±20．80）s，其中男（30．47±21．97）s，女（34．26±18．22）s；最长中枢性呼吸暂停时间（MCAT）为（14．45±6．55）s，其中男（14．34±7．59）s，女（14．78±4．54）s；最长低通气时间（MHT）为（57．04±25．22）s，其中男（53．80±21．95）s，女（62．20±30．68）s；阻塞性呼吸暂停指数（OAI）为6．00±6．44，其中男5．44±7．37，女7．33±3．93；中枢性呼吸暂停指数（CAI）为0．85±1．00，其中男0．79±1．07，女0．98±0．87；低通气指数（HI）为5．68±6．04，其中男5．72±5．00，女5．60±7．84；最低血氧（minimumSaO2）为（83．26±12．88）％，其中男（81．97±12．93）％，女（85．58±15．87）％；微觉醒指数（arousalindex，Arousals）为26．39±12．46，其中男28．09±13．58，女22．75±9．29。125例疑似OSAHS儿童中，2例（1．6％，2／125）诊断为正常，13例（10．4％，13／125）诊断为上气道阻力综合征，41例（32．8％，41／125）诊断为轻度OSAHS，47例（37．6％，47／125）诊断为中度OSAHS，22例（17．6％，22／125）诊断为重度OSAHS。对不�Objective To explore the application of pulse transit time （PTT） in evaluating obstructive sleep apnea hypopnea syndrome（OSAHS） in children and to introduce the principle and manipulation of PTT. PTT is the time the pulse wave （PW） travells between two arterial sites （ normally heart to finger）. Methods One hundred and twenty-five children suspected of OSAHS underwent All-night PTI＂ test. The following parameters were measured ： chest and abdominal wall movement by respiratory inductance plethysmography, heart rate by electrocardiogram, PTT and arterial oxygen saturation were recorded using ECG and pulse oximetry. Nasal airflow was measured by nasal catheter and thermistor. The apnea events and hypopnea events were determined by nasal/mouth airflow. The obstructive and central events were differentiated by combining the changes of PTT and nasal/mouth airflow. Then PTT values were recorded and analyzed with a statistical software program （Version 11.0; SPSS）. Results All of the 125 children （age range, 2 to 12 years; mean age.5 years and 8 months old; 85 male children, 40 female children） underwent PTT monitoring. The results were as followings： The mean maximum obstructive apnea duration was （ 32. 02 ±20. 80）s [male （30.47 ± 21.97） s ,female （34. 26 ± 18.22） s respectively]. The mean maximum central apnea duration was （ 14. 45 ± 6. 55 ） s [ male （ 14. 34 ± 7. 59） s, female （ 14. 78 ± 4. 54） s, respectively ]. The mean hypopnea duration was （ 57.04 ± 25. 22）s[ male （53.80 ±21.95）s, female （62. 2 ±30.68）s, respectively]. The obstructive apnea index （OAI） was 6. 00 ±6. 44 （ male 5.44 ± 7. 37, female 7.33 ± 3.93, respectively）, central apnea index （CAI） was 0. 85 ± 1.00 （ male 0.79 ± 1.07, female 0. 98 ±0. 87, respectively）, hypopnea index （HI） was 5.68 ±6. 04（male 5.72 ±5.0, female 5.60 ±7. 84, respectively）, saO2 nadir was 83. 26 ± 12. 88% [ male （81.97 ± 12. 93 ）%, female （85.58 ± 15.87 ）% , respe

关 键 词：儿童 睡眠 呼吸暂停 脉搏传导时间 

分 类 号：R725.6[医药卫生—儿科]