阻塞性睡眠呼吸暂停低通气综合征儿童手术前后视听整合连续测试对比研究  

Impact in response control, attention and hyperactivity behavior on children with obstructive sleep apnea hypopnea syndrome by integrated visual and auditory continuous performance test

作　　者：王海飞[1] 朱瑾[1] 方瑜[1] 陈鑫[1] 张海生[2] 陆锦莲[1] 

机构地区：[1]南京医科大学附属杭州医院杭州市第一人民医院耳鼻咽喉头颈外科,310006 [2]南京医科大学附属杭州医院杭州市第一人民医院临床心理科310006

出　　处：《中华耳鼻咽喉头颈外科杂志》2013年第3期213-217,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的通过视听整合连续测试（integrated visual and auditory continuous performancetest，IVA—CPT）研究阻塞性睡眠呼吸暂停低通气综合征（OSAHS）对儿童反应控制力、注意力和多动行为的影响。方法51例经多道睡眠图（PSG）监测确诊为OSAHS的5～12岁患儿行双侧扁桃体＋腺样体或单纯腺样体切除术，并在术前、术后3个月、术后6个月3个时间点（下称第1、2、3时间点）行IVA．CPT和PSG检测。按病程分组（分为病程〈5年组和1〉5年组），用SPSS19．0软件对检测结果进行统计学分析。结果两组不同病程患儿术前性别、体质量指数（BMI）、病情严重程度分布均衡，差异无统计学意义（P值均〉0．05）。51例中3个时间点患儿精神心理行为异常例数分别为32例（62．7％）、25例（49．0％）和8例（15．7％），第1、2时间点间异常率比较差异无统计学意义（x。=1．49，P=0．163）；第2、3时间点间异常例数比较差异有统计学意义（X^2=12．95，P〈0．001）。重复测量方差分析显示两组患儿综合尺度反应控制商数（full scale response control quotient，FRCQ）、综合尺度注意力商数（full scale attention quotient，FAQ）和多动商数（hyperactivity，HYP）各时间点平均值均随时间延长逐渐改善，差异均有统计学意义（F值分别为342．15、263．12、380．57，P值均〈0．001）；不同病程组间各时间点比较差异也有统计学意义（F值分别为167．05、126．47、117．683，P值均〈0．001），且FRCQ和HYP在病程〈5年和i〉5年两组间分别存在交互作用（P值均〈0．001）。不同病程组患儿的呼吸暂停低通气指数（AHI）、最低动脉血氧饱和度（LaSO：）组内各时间点比较，差异均有统计学意义（F值分别为99．057和70．742，P值均〈0．001）。不同病程组间各时间点AHI、LaSO2比较，AHI和LaSO2差异均无统计学意义（P〉0．05）。AHI和LaSO2不存在�Objective To study the impact in response control, attention and hyperactivity behavior on children with obstructive sleep apnea hypopnea syndrome （OSAHS） by the integrated visual and auditory continuous performance test （IVA-CPT）. Methods Fifty-one children aged between 5 and 12 years were diagnosed as OSAHS by polysomnography （PSG） , and received adenotonsilleetomy and adenoideetomy or only adenoidectomy. Then received IVA-CPT and PSG before surgery, 3 months after surgery and 6 months after surgery （ named as first, second and third time point）. These children were divided into two groups according to the disease course （ group A ： course of disease 〈 5 years ; group B ： course of disease ≥ 5 years）. The SPSS 19. 0 was used for statistical analysis. Results By balanced test, there were no differences in gender, body mass index （BMI） and disease severity among the two groups before surgery （P 〉 0. 05）. The numbers of children with abnormal psychological behavior at three time points were32（62. 7% ）, 25（49.0% ） and 8（ 15.7% ）. The abnormal rate did not show statistical difference between the first and second time point （ X^2 = 1.49, P = 0. 163 ）, but did show statistical difference between the second and third time point （ X^2 = 12. 95, P 〈 0. 001 ）. Repetitive measurement and analysis of variance showed that there were statistical differences in means of FRCQ, FAQ and HYP between three time points in two groups（F were 342. 15, 263.12, 380. 57, P 〈 0. 001 ） , and all the means improved with time. It also showed that there were statistical differences in means of FRCQ, FAQ and HYP between two groups at every time point（F were 167.05, 126. 47, 117. 683, P 〈0. 001 ）. FRCQ and HYP all showed interation effect between two groups （ P 〈0. 001 ）. Means of apnea hypopnea index （AI-II） and lowest arterial （ LaSO2 ） were compared between three time points in two groups and all showed statistical differences （ F were 99. 057, 70. 742, P

关 键 词：睡眠呼吸暂停 阻塞性 儿童 注意力缺陷障碍伴多动 神经心理学测验 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]