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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

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

    摘要
  • 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。

     

    Abstract:
      Objective  To compare and analyze the clinical manifestations and sleep structure of children with obstructive sleep apnea-hypopneasyndrome (OSAHS) with different body mass index (BMI).
      Methods  452 children who were diagnosed with OSAHS between December 2016 and February 2021 by the Department of Respiratory Medicine, Children’s Hospital of Soochow University were included in the study. All of them did polysomnography (PSG). They were divided, according to their BMI, into the normal BMI group, the overweight group, and the obesity group. Their clinical data and PSG results were collected.
      Results  287 boys (63.5%) and 165 girls (36.5%) were enrolled, with their age ranging between 3 and 15, and the median age being 5.5 (4.5, 7.0). Their BMI ranged between 12.09 kg/m2 and 38.48 kg/m2, with the median being 16.29 kg/m2. 275 cases (60.8%) had normal BMI, 76 cases (16.8%) were overweight, and 101 cases (22.3%) were obese. There was no significant difference in the distribution of clinical manifestations and severity of OSAHS among the three groups. The duration and proportion of rapid eye movement (REM) stage sleep in the obese group was lower than that of the overweight and the normal BMI groups (P<0.05). The lowest oxyhemoglobin saturation (LSaO2) of children in the overweight group was lower than that of the normal BMI group (P=0.050). The oxygen desaturation index (ODI) of the obese group was higher than that of the normal BMI and the overweight groups (P<0.05).
      Conclusion  Obesity worsens the degree of hypoxia in children with OSAHS and affects their sleep structure.

     

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