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不同BMI阻塞性睡眠呼吸暂停低通气综合征患儿临床表现及睡眠结构比较

徐雪云 王宇清 何燕玉 郝创利 耿雅轩 江雨婷 吕梦 王志辉

徐雪云, 王宇清, 何燕玉, 等. 不同BMI阻塞性睡眠呼吸暂停低通气综合征患儿临床表现及睡眠结构比较[J]. 四川大学学报(医学版), 2021, 52(5): 844-848. doi: 10.12182/20210960105
引用本文: 徐雪云, 王宇清, 何燕玉, 等. 不同BMI阻塞性睡眠呼吸暂停低通气综合征患儿临床表现及睡眠结构比较[J]. 四川大学学报(医学版), 2021, 52(5): 844-848. doi: 10.12182/20210960105
XU Xue-yun, WANG Yu-qing, HE Yan-yu, et al. Comparative Study of Clinical Manifestations and Sleep Structure in Children with Obstructive Sleep Apnea-hypopnea Syndrome with Different BMI[J]. JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCE EDITION), 2021, 52(5): 844-848. doi: 10.12182/20210960105
Citation: XU Xue-yun, WANG Yu-qing, HE Yan-yu, et al. Comparative Study of Clinical Manifestations and Sleep Structure in Children with Obstructive Sleep Apnea-hypopnea Syndrome with Different BMI[J]. JOURNAL OF SICHUAN UNIVERSITY (MEDICAL SCIENCE EDITION), 2021, 52(5): 844-848. doi: 10.12182/20210960105

不同BMI阻塞性睡眠呼吸暂停低通气综合征患儿临床表现及睡眠结构比较

doi: 10.12182/20210960105
基金项目: 国家自然科学基金(No. 81573167)和江苏省重点科技社会发展项目(No. BE2016676,No. BE2017657)资助
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    E-mail:wang_yu_qing@126.com

Comparative Study of Clinical Manifestations and Sleep Structure in Children with Obstructive Sleep Apnea-hypopnea Syndrome with Different BMI

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  • 摘要:   目的  比较分析不同体质量指数(body mass index, BMI)的阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome, OSAHS)患儿临床表现及睡眠结构。  方法  收集2016年12月−2021年2月到苏州大学附属儿童医院呼吸科就诊,完善了多导睡眠监测(polysomnography, PSG),并诊断为OSAHS的452例患儿为研究对象。根据BMI分为BMI正常组、超重组、肥胖组,收集临床资料及PSG监测结果。  结果  入组男性患儿287例(63.5%),女性患儿165例(36.5%);年龄3~15岁,中位年龄5.5(4.5,7.0)岁;BMI范围12.09~38.48 kg/m2,中位数16.29 kg/m2,BMI正常275例(60.8%),超重76例(16.8%),肥胖101例(22.3%)。3组患儿临床表现及OSAHS严重程度的分布差异无统计学意义;肥胖组患儿快速眼动(rapid eye movement, REM)期睡眠时间及比例分别低于超重组及BMI正常组(P<0.05);超重组患儿最低血氧饱和度(lowest oxyhemoglobin saturation, LSaO2)低于BMI正常组(P=0.05),肥胖组患儿氧减指数(oxygen desaturation index, ODI)分别高于BMI正常组和超重组(P<0.05)。  结论  肥胖会加重OSAHS患儿的缺氧程度并影响睡眠结构。
  • 表  1  不同肥胖程度OSAHS患儿性别及年龄分布比较

    Table  1.   Comparison of gender and age distribution of OSAHS patients with different obesity levels

    ItemNormal BMI group (n=275)Overweight group (n=76)Obesity group (n=101)χ2P
    Male/case (%) 162 (58.9) 54 (71.1) 71 (70.3) 6.384 0.042
    Female/case (%) 113 (41.1) 22 (28.9) 30 (29.7)
    ≤6 years old/case (%) 180 (65.5) 56 (73.7) 59 (58.4) 4.471 0.111
    >6 years old/case (%) 95 (34.5) 20 (26.3) 42 (41.6)
    下载: 导出CSV

    表  2  不同肥胖程度OSAHS患儿临床表现及严重程度的比较

    Table  2.   Comparison of clinical manifestations and severity of OSAHS patients with different obesity levels

    Clinical symptomsNormal BMI group (n=275)Overweight group (n=76)Obesity group (n=101)χ2P
    Snoring/case (%) 247 (89.9) 73 (96.1) 95 (94.1) 3.952 0.130
    Mouth breathing/case (%) 219 (79.6) 59 (77.6) 82 (81.2) 0.338 0.831
    Labored breathing/case (%) 98 (35.6) 29 (38.2) 40 (39.6) 0.557 0.765
    Apnea/case (%) 61 (22.2) 8 (10.5) 24 (23.8) 5.758 0.056
    Oppressive wake/case (%) 30 (10.9) 14 (18.4) 15 (14.9) 3.331 0.194
    Nocturia/case (%) 36 (13.1) 10 (13.2) 20 (19.8) 2.821 0.252
    Enuresis/case (%) 37 (13.5) 8 (10.5) 17 (16.8) 1.498 0.495
    Difficulty getting up in the morning/case (%) 103 (37.5) 22 (28.9) 36 (35.6) 1.879 0.398
    Morning headaches/case (%) 8 (2.9) 1 (1.3) 5 (5.0) 1.992 0.370
    Daytime sleepiness/case (%) 37 (13.5) 8 (10.5) 17 (16.8) 1.498 0.495
    Social withdrawal/case (%) 24 (8.7) 7 (9.2) 13 (12.9) 1.472 0.466
    Hyperactivity/case (%) 107 (38.9) 24 (31.6) 39 (38.6) 1.419 0.487
    Inattention/case (%) 114 (41.5) 30 (39.5) 48 (47.5) 1.451 0.477
    Severity of OSAHS/case (%)
     Mild 198 (72.0) 54 (71.1) 71 (70.3) 0.112 0.945
     Moderate 38 (13.8) 11 (14.5) 10 (9.9) 1.161 0.590
     Severe 39 (14.2) 11 (14.5) 20 (19.8) 1.854 0.406
    下载: 导出CSV

    表  3  不同肥胖程度OSAHS患儿睡眠结构的组间比较

    Table  3.   Comparison of sleep structure in OSAHS children with different obesity levels

    ItemNormal BMI group (n=275)Overweight group (n=76)Obesity group (n=101)HP
    TST/min 480.5 (430.0, 522.0) 466.7±65.6 473.5 (424.0, 500.5) 3.309 0.191
    SE/% 84.3 (76.4, 90.5) 81.9 (74.8, 89.2) 82.5 (75.8, 87.6) 3.335 0.187
    Sleep latency/min 23.5 (8.5, 44.0) 22.1 (8.0, 56.4) 21.0 (7.8, 52.3) 0.597 0.742
    Arousal index/(time/h) 16.0 (12.0, 21.0) 16.0 (11.0, 22.0) 15.0 (10.0, 19.0) 3.234 0.199
    NREM proportion/%
     NREM1 11.6 (6.9, 15.0) 10.3 (6.9, 14.0) 10.6 (5.4, 14.5) 2.173 0.337
     NREM2 46.1±9.2 45.2±9.5 49.8 (42.1, 54.8) 5.511 0.064
     NREM3 22.0 (18.1, 25.4) 22.4±6.8 23.5 (17.7, 25.3) 0.108 0.948
    REM proportion/% 20.5 (18.0, 22.9) 21.4±4.7 19.2 (17.1, 21.5)*, # 13.010 0.001
    REM/min 97.1±28.8 97.5 (81.5, 119.9) 88.2±23.1*, # 10.705 0.005
    LSaO2/% 90.0 (87.0, 92.0) 88.5 (85.0, 91.0) * 89.0 (86.0, 91.0) 6.559 0.038
    ODI/(time/h) 0.7 (0.2, 1.9) 0.8 (0.3, 2.3) 1.0 (0.5, 3.7)*, # 5.978 0.050
    OAHI/(time/h) 2.7 (1.6, 6.1) 2.9 (1.8, 6.7) 2.9 (1.8, 8.5) 0.929 0.682
    REM-AI/(time/h) 3.6 (1.7, 7.4) 3.3 (1.4, 6.9) 2.6 (0.9, 4.3)* 13.418 0.001
     TST: Total sleep time; SE: Sleep efficiency; NREM: Non-rapid eye movement; REM: Rapid eye movement; LSaO2: Lowest oxyhemoglobin saturation; ODI: Oxygen desaturation index; OAHI: Obstructive apnea-hypopnea index; REM-AI: Rapid eye movement-apnea index. *P<0.05, vs. normal BMI group; # P<0.05, vs. overweight group. Normally distributed numbers are represented as $ \bar {x} $±s; Non-normally distributed numbers are represented as median (P25, P75).
    下载: 导出CSV

    表  4  BMI与不同严重程度OSAHS患儿睡眠结构的相关性分析

    Table  4.   Correlation analysis between BMI and sleep structure of children with different severity of OSAHS

    Sleep structureMild OSAHSModerate OSAHSSevere OSAHS
    rPrPrP
    NREM1 proportion −0.080 0.152 0.019 0.886 −0.053 0.662
    NREM2 proportion 0.116 0.038 0.115 0.388 0.124 0.308
    NREM3 proportion −0.016 0.771 −0.080 0.549 −0.172 0.156
    REM proportion −0.116 0.037 −0.256 0.051 −0.009 0.941
    下载: 导出CSV
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出版历程
  • 收稿日期:  2021-05-25
  • 修回日期:  2021-08-07
  • 网络出版日期:  2021-09-24
  • 刊出日期:  2021-09-20

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