阻塞性睡眠呼吸暂停低通气综合征合并注意缺陷多动障碍患儿临床特征分析  

Clinical manifestation of children with obstructive sleep apnea hypopnea syndrome combined with attention deficit hyperactivity disorder

作　　者：吴佳欐[1] 顾美珍[1] 陈淑梅[1] 陈伟[1] 倪坤[1] 徐宏鸣[1] 张艳平[1] 张泓[1] 李晓艳[1] WU Jia-li GU Mei-zhen CHEN Shu-mei CHEN Wei NI Kun XU Hong-ming ZHANG Yan-ping ZHANG Hong LI Xiao-yan.(Department of Otorhinolaryngology, Children＇s Hospital of Shanghai, Shanghai 200062, Chin)

机构地区：[1]上海交通大学附属儿童医院(上海市儿童医院)耳鼻咽喉头颈外科,上海200062

出　　处：《中国眼耳鼻喉科杂志》2017年第4期252-255,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：上海市儿童医院院级课题科研基金资助项目(2012M013)

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并注意缺陷多动障碍(ADHD)患儿的临床特征。方法 2014年1~12月在本院住院的OSAHS患儿437例,根据有无ADHD分为单纯OSAHS组和OSAHS合并ADHD组。比较2组患儿OSA-18,睡眠监测[呼吸暂停低通气指数(AHI)、最低氧饱和度],血清多巴胺、去甲肾上腺素的差异。结果合并ADHD的患儿睡眠呼吸事件的次数更多(P<0.01),最低氧饱和度也更低(P<0.01),睡眠障碍较单纯OSAHS患者更严重。4~5岁组,OSAHS合并ADHD患儿多巴胺、多巴胺/去甲肾上腺素均更高(P<0.01)。6~11岁组,OSAHS合并ADHD患儿去甲肾上腺素更低(P<0.05),多巴胺/去甲肾上腺素更高(P<0.01),差异均有统计学意义。结论 OSAHS合并ADHD的患儿夜间睡眠缺氧更严重,多巴胺/去甲肾上腺素更高,多巴胺与去甲肾上腺素的不平衡与ADHD发病有关。Objective To investigate the clinical manifestation of children of obstructive sleep apnea hypopnea syndrome （OSAHS） combined with attention deficit hyperactivity disorder （ADHD）. Methods Four hundred and thirty-seven children hospitalized for OSAHS from January to December in 2014 were included in this trial. According to the presence of ADHD and ADHD classification, the children were divided into pure OSAHS group and merging ADHD group. The patient ＇s OSA-18, sleep monitoring [ apnea hypopnea index （AHI）, lowest oxygen saturation], serum dopamine and norepinephrine were investigated. Results Respiratory events among children combined with ADHA were more serious than pure OSAHS patients （P 〈 0.01 ）, oxygen deficiency and sleep disorder were also more serious （P 〈 0.01 ）. In group of 4 - 5 years old, higher level of dopamine, dopamine/norepinephrine occurred in children combined with ADHD （P 〈 0. 01 ）. In group of 6 -11 years old, higer level of dopamine/norepinephrine and lower value of norepinephrine occurred in children combined with ADHD. The difference was statistically significant. Conclusions Sleep disorders among children merging of ADHD are heavier, and the patients has a higher level of dopamine/ norepinephrine. The imbalance between dopamine and norepinephrine might be related to the pathogenesis of ADHD.

关 键 词：注意缺陷多动障碍 阻塞性睡眠呼吸暂停低通气综合征 多巴胺 去甲肾上腺素 儿童 

分 类 号：R749.94[医药卫生—神经病学与精神病学] R766[医药卫生—临床医学]