儿童过敏性鼻炎的阻塞性睡眠呼吸障碍特征分析  

Characteristics of obstructive sleep apnea in children with allergic rhinitis

作　　者：黄晓 杨琴[1] 刘爱良 王聪聪 李嘉慧 鲍燕敏[1] 王文建[1] 郑跃杰[1] 潘宏光[2] Huang Xiao;Yang Qin;Liu Ailiang;Wang Congcong;Li Jiahui;Bao Yanmin;Wang Wenjian;Zheng Yuejie;Pan Hongguang(Department of Respiratory Medicine,Shenzhen Children′s Hospital,Shenzhen 518038,China;Department of Otolaryngological Medicine,Shenzhen Children′s Hospital,Shenzhen 518038,China)

机构地区：[1]深圳市儿童医院呼吸科,518038 [2]深圳市儿童医院耳鼻喉科,518038

出　　处：《中国小儿急救医学》2022年第8期622-625,共4页Chinese Pediatric Emergency Medicine

基　　金：深圳市医学重点学科建设经费(SZXK032)。

摘　　要：目的:分析儿童过敏性鼻炎(AR)的睡眠呼吸障碍(SDB)特征,提高对儿童AR合并阻塞性睡眠呼吸暂停(OSA)的诊治认识。方法:回顾性分析深圳市儿童医院呼吸科2019年5月至2020年12月收治的120例AR并OSA的病例资料(AR并OSA组),选取同期诊断OSA并排除AR的120例患儿作为对照组。比较两组患儿的SDB日夜间症状、睡眠结构特征、睡眠呼吸事件。结果:AR并OSA组患儿平均病程较对照组明显延长( P=0.030);AR并OSA组患儿主要表现为张口呼吸(100.0%)、打鼾(99.2%)、鼻塞(88.5%)、睡眠不安(68.0%);两组患儿的睡眠结构比较差异无统计学意义( P>0.05),AR并OSA组睡眠效率较对照组显著降低,差异有统计学意义( P=0.028);AR并OSA组患儿呼吸暂停低通气指数、阻塞性呼吸暂停指数、阻塞性呼吸暂停/低通气指数、低通气指数及各睡眠期氧减指数较对照组显著增多,两组比较差异均有统计学意义( P均<0.05);AR并OSA组患儿以中度、重度OSA为主要表现,两组比较差异有统计学意义( P<0.001)。 结论:合并AR使OSA儿童病程迁延;AR患儿的SDB特征主要表现为睡眠时张口呼吸、睡眠不安、打鼾、鼻塞,其睡眠效率下降,呼吸事件以阻塞性低通气及暂停更常见,氧减多发生在快速动眼期。合并AR儿童更易出现中度、重度OSA。Objective To analyze the characteristics of sleep disordered breathing(SDB)in children with allergic rhinitis(AR),and improve the diagnosis and treatment at AR combined with obstructive sleep apnea(OSA).Methods The clinical data of 120 patients with AR and OSA(AR and OSA group)admitted to the respiratory department at Shenzhen Children′s Hospital from May 2019 to December 2020 were retrospectively analyzed.A total of 120 children diagnosed with OSA and excluded AR during the same period were selected as control group.The SDB day and night symptoms,sleep structure characteristics and sleep breathing events were compared between two groups.Results The average course of disease in children with AR and OSA was significantly longer than that in control group(P=0.030).The main manifestations of children in AR and OSA group were mouth breathing(100.0%),snoring(99.2%),nasal obstruction(88.5%),and restless sleep(68.0%).There was no significant difference in sleep structure between two groups(P>0.05),but the sleep efficiency of AR and OSA group was significantly lower than that of control group(P=0.028).The respiratory events apnea hypopnea index,obstructive apnea index,obstructive apnea hypopnea index,hypopnea index and oxygen desaturation index of each sleep period in AR and OSA group were significantly higher than those in control group(P<0.05).Among the children in AR and OSA group,moderate and severe OSA were the main manifestations,and the difference between two groups was statistically significant(P<0.001).Conclusion The combination of AR delayed the course of OSA in children.The main characteristics of sleep disordered breathing in children with AR are mouth opening,restless sleep,snoring and nasal obstruction.The sleep efficiency is decreased.Obstructive hypopnea and apnea are the most common respiratory events,and oxygen deficiency often occurs in rapid eye movement phase.Children with AR are more likely to have moderate or severe obstructive sleep apnea.

关 键 词：儿童 过敏性鼻炎 阻塞性睡眠呼吸暂停 多导睡眠监测 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]