儿童支气管哮喘合并阻塞性睡眠呼吸暂停低通气综合征的临床特征及影响因素研究  

Clinical Characteristics and Influencing Factors of Bronchial Asthma Combined with Obstructive Sleep Apneahypopnea Syndrome in Children

作　　者：梁譞 那飞扬 秦梦瑶 杨辉[1] 郭丽[1] 郭琪 任蕾 陈德 刘东海 张蓉芳[1,2] LIANG Xuan;NA Feiyang;QIN Mengyao;YANG Hui;GUO Li;GUO Qi;REN Lei;CHEN De;LIU Donghai;ZHANG Rongfang(Children's Asthma Center,Gansu Provincial Maternity and Children Health Care Hospital,Lanzhou 730050,China;Gansu University of Chinese Medicine,Lanzhou 730000,China;Second Provincial People's Hospital of Gansu,Lanzhou 730000,China)

机构地区：[1]甘肃省妇幼保健院儿童哮喘中心,甘肃省兰州市730050 [2]甘肃中医药大学,甘肃省兰州市730000 [3]甘肃省第二人民医院,甘肃省兰州市730000

出　　处：《中国全科医学》2023年第33期4225-4230,共6页Chinese General Practice

基　　金：甘肃省自然科学基金资助项目(21JR7RA662);甘肃省卫生健康行业科研项目(GSWSKY2021-073);兰州市科技计划项目(2022-5-74)。

摘　　要：背景支气管哮喘(BA)和阻塞性睡眠呼吸暂停低通气综合征(OSAHS)是困扰儿童健康的两大慢性疾病,合并OSAHS可能使BA病情加重,BA又可通过多种机制导致OSAHS的发生或进展,两者关系日益受到关注。目的探讨儿童BA合并OSAHS的临床特征及影响因素。方法选取2021年9月—2022年8月在甘肃省妇幼保健院儿童哮喘中心就诊的BA患儿109例为研究对象,根据是否合并OSAHS,分为BA合并OSAHS组(n=49)和单纯BA组(n=60),收集患儿的一般临床资料、肺功能检查、血清炎性细胞因子、25-羟维生素D[25-(OH)D]及C反应蛋白(CRP)检测结果,分析BA合并OSAHS患儿的临床特征,并采用多因素Logistic回归分析探讨BA患儿合并OSAHS的影响因素。结果多因素Logistic回归分析结果显示肥胖[OR=4.803,95%CI(1.011,2.822)]、颈围增大[OR=1.318,95%CI(1.003,1.732)]、合并胃食管反流病(GERD)[OR=7.756,95%CI(1.398,43.045)]是BA患儿合并OSAHS的独立危险因素(P<0.05);25-(OH)D水平升高[OR=0.830,95%CI(0.757,0.910)]是BA患儿合并OSAHS的保护因素(P<0.05)。结论BA合并OSAHS患儿的肺功能指标低于单纯BA患儿,肥胖、颈围、合并GERD、25-(OH)D水平是BA合并OSAHS患儿的影响因素。Background Bronchial asthma(BA)and obstructive sleep apnea-hypopnea syndrome(OSAHS)are two major chronic diseases affecting the health of children.OSAHS may aggravate BA,adding to the difficulties in BA control,and BA can lead to the occurrence or progression of OSAHS through various mechanisms,such a relationship between them has attracted increasing attention.Objective To explore the clinical features and influencing factors of children with BA complicated with OSAHS.Methods One hundred and nine children with BA who were admitted to Children's Asthma Center,Gansu Provincial Maternity and Child Health Care Hospital from September 2021 to August 2022 were selected,including 49 with OSAHS(BA with OSAHS group)and 60 without(simple BA group).The general clinical data,pulmonary function test results,and serum levels of inflammatory cytokines,25-hydroxyvitamin D〔25(OH)D〕and C-reactive protein(CRP)were collected.The clinical features were analyzed,and factors associated with OSAHS in BA were analyzed by multivariate Logistic regression.Results Multivariate Logistic regression analysis showed that obesity〔OR=4.803,95%CI(1.011,2.822)〕,enlarged neck circumference〔OR=1.318,95%CI(1.003,1.732)〕and gastroesophageal reflux disease(GERD)〔OR=7.756,95%CI(1.398,43.045)〕were independent risk factors for OSAHS in BA children(P<0.05),while elevated 25-(OH)D〔OR=0.830,95%CI(0.757,0.910)〕was a protective factor for OSAHS in BA children(P<0.05).Conclusion The values of pulmonary function indices of children with BA complicated with OSAHS were lower than those of children with simple BA.Obesity,enlarged neck circumference,GERD and 25-(OH)D level were the influencing factors of OSAHS in BA children.

关 键 词：哮喘 睡眠呼吸暂停 阻塞性 儿童 呼吸道疾病 临床特征 影响因素分析 LOGISTIC模型 

分 类 号：R562.25[医药卫生—呼吸系统]