血氧相关指标在小儿上气道阻塞疾病诊断中的临床价值  

Clinical Value of Blood Oxygen Related Indexes in the Diagnosis of Upper Airway Obstruction in Children

作　　者：许燕娇 郭宇峰 高兴强 邓海燕 吴晓慧 XU Yanjiao;GUO Yufeng;GAO Xingqiang;DENG Haiyan;WU Xiaohui(Xiamen Children's Hospital,Xiamen 361003,China)

机构地区：[1]厦门市儿童医院,福建厦门361006

出　　处：《中国医药指南》2021年第35期7-9,共3页Guide of China Medicine

基　　金：厦门市儿童医院青年科研项目(项目编号:CHP-2019-YRF-0010);福建省卫生教育联合攻关计划项目(项目编号:2019-WJ-33);厦门市医疗卫生科技计划项目(项目编号:3502Z20194085)。

摘　　要：目的探讨小儿上气道阻塞疾病低氧血症程度的评估指标。方法分析经多导睡眠呼吸监测仪诊断的72例OSAHS患者和6例单纯鼾症的多导睡眠监测资料。单纯打鼾组与OSAHS组的血氧饱和度<90%时间占监测总时间的百分比(time spent below oxygen saturation of 90%,TS90%)比较采用Mann-Whitney检验;不同严重程度OSAHS组的TS90%比较采用单因素方差分析;应用Spearman相关分析评价各组间的相关性,计算呼吸暂停低通气指数(apnea hypopnea index,AHI)与TS90%、氧减指数(oxygen desaturation index,ODI)、最低血氧饱和度(lowest oxygen saturation,LSpO;)的相关系数。结果各组之间的AHI、ODI、最长氧减、TS90%的差异均有统计学意义(P <0.05),LSpO;在各组之间的差异也有统计学意义(P <0.05)。单纯打鼾组秩平均为20.33,OSAHS组秩平均为41.10,两组组间差异有统计学意义(P <0.05)。根据AHI分组,轻度31例,中度25例,重度16例,轻、中、重度OSAHS组的TS90%分别为(0.13±0.28)、(1.36±5.43)、(3.99±4.77),3组患者TS90%比较的差异均有统计学意义(P <0.05)。AHI与TS90%、ODI的相关系数分别为0.346、0.555,有统计学意义(P <0.05)。AHI与LSpO;为负相关,相关系数为-0.436,有统计学意义(P <0.05)。结论 TS90%能较为客观地反映患者睡眠时低氧血症的严重程度,OSAHS患者缺氧严重程度的评估不能仅考虑单一指标,需结合ODI、LSpO;、TS90%指标综合判断,更为完善地判断OSAHS患者夜间低氧血症的程度。Objective To evaluate the degree of hypoxemia in children with upper airway obstruction. Methods Polysomnography monitoring data of 72 patients with OSAHS and 6 patients with simple snoring were analyzed. Mann-whitney test was used to compare the time spent below oxygen saturation of 90%(TS90%) between the snoring group and the OSAHS group. The ts90% of OSAHS groups with different severity was compared by one-way anOVA. Spearman correlation analysis was used to evaluate the correlation between each group. Apnea hypopnea index(AHI), TS90%and Oxygen desaturation index(AHI) were calculated. ODI) and Lowest oxygen saturation(LSpO_(2)). Results There were statistically significant differences in AHI, ODI, MAXIMUM oxygen loss and TS90% among all groups(P <0.05), and there were also statistically significant differences in LSpO_(2) among all groups(P <0.05). The rank mean of the snoring group was 20.33 and that of the OSAHS group was 41.10, with a statistically significant difference between the two groups(P <0.05). According to AHI grouping, there were 31 cases of mild, 25 cases of moderate and 16 cases of severe OSAHS. Ts90% of the mild, moderate and severe OSAHS groups were(0.13±0.28),(1.36±5.43) and(3.99±4.77), respectively,with statistical significance(P <0.05). The correlation coefficients between AHI and TS90% and ODI were 0.346 and 0.555, respectively, with statistical significance(P <0.05). AHI was negatively correlated with LSpO_(2), with a correlation coefficient of-0.436(P <0.05). Conclusion TS90%can objectively reflect the severity of hypoxemia in patients during sleep. The evaluation of the severity of hypoxemia in patients with OSAHS should not only consider a single indicator, but should be combined with ODI, LSpO_(2) and TS90% indexes to better judge the degree of hypoxemia at night in patients with OSAHS.

关 键 词：小儿鼾症 阻塞性睡眠呼吸暂停低通气综合征 睡眠呼吸暂停低通气指数 氧减指数 

分 类 号：R563.9[医药卫生—呼吸系统]