儿童阻塞性睡眠呼吸暂停低通气综合征合并与不合并注意缺陷/多动障碍的多导睡眠图的比较  

Comparison of the sleep architecture and principal variables of PSG study in children with OSAHS either with or without ADHD.

作　　者：黄振云[1] 刘大波[1] 李志斌[1] 钟建文[1] 俞洁[1] 谭宗瑜[1] 孙昌志[1] 周丽枫[1] 陈倩[1] 

机构地区：[1]广州市儿童医院神经康复科,广东广州510120

出　　处：《中国实用儿科杂志》2007年第4期261-263,共3页Chinese Journal of Practical Pediatrics

基　　金：广东省科技厅资助项目(No.2005B30010231);广州市医药卫生科技一般引导项目(No.2006-YB-076)

摘　　要：目的通过对比合并与不合并注意缺陷多动障碍(ADHD)的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)儿童的多导睡眠监测指标,试图从睡眠结构和睡眠主要参数的层次上来探讨ADHD的发病机制。方法选择2004-01—2006-10于广州市儿童医院就诊的OSAHS患儿36例作为OSAHS组,合并有OSAHS的ADHD患儿20例作为观察组,选取无OSAHS及ADHD的儿童30例作为对照组,三组之间在年龄、性别、体重指数等方面相比,差异无显著性。通过多导睡眠监测(PSG),并由神经康复科专科医生对其是否患有ADHD作出诊断。采用相应的统计学方法,对OSAHS组、观察组及对照组的睡眠结构进行比较,并对OSAHS组和观察组进行呼吸事件及血氧状况的比较。结果(1)与对照组相比,OSAHS组及观察组睡眠Ⅰ期增加,睡眠Ⅱ期、SWS及REM睡眠减少,差异有统计学意义(P<0.05),OSAHS组的REM%为8.66±3.94,观察组的REM%为5.65±5.41,REM%的改变有统计学意义(P<0.05)。(2)观察组儿童呼吸事件的次数与持续时间及血氧饱和度下降较OSAHS儿童严重,差异有统计学意义(P<0.05)。结论观察组儿童REM%及血氧饱和度的下降可能在ADHD的发病中起一定的作用。Objective To compare the sleep architecture and principal variables of a PSG study carried out in children with either OSAHS or OSAHS ＋ ADHD. The study is to evaluate the role of sleep architecture and principal variables of PSG Study in pathogenesis of ADHD. Methods The sleep architecture were compared among the OSAHS group （ n = 36 ） and study group （ OSAHS ＋ ADHD, n = 20 ） and control group（ without OSAHS and ADHD, n = 30 ）. The respiratory events and SaO2 were compared between the study group and OSAHS group. All children underwent PSG montoring and diagnostic and statistical manual of mental disorder（ DSM-Ⅳ ） were used to diagnose whether children had ADHD or not. Results （ 1 ） The sleep architecture of children in study group and OSAHS group presented differences as compared to control group in an increase in the percentage of phase Ⅰ sleep and a decrease in the percentage of phase Ⅱ sleep, SWS and REM sleep （ P 〈 0. 05 ） The decrease of REM% was significant when compared between study group and OSAHS group （ P 〈 0. 05 ）. （ 2 ） The times and duration of respiratory events and decrease of SaO2 were severer than that in OS- AHS group. The difference was significant [ P 〈 0. 05 ）. Conclusion Thedecrease of REM% and SaO2 may play a role in pathogenesis of ADHD.

关 键 词：儿童 注意力缺陷多动障碍 阻塞性睡眠呼吸暂停低通气综合征 多导睡眠图 

分 类 号：R72[医药卫生—儿科]