Masters I B, Harvey J M, Wales P D, O'Callaghan M J, Harris M A
Department of Respiratory Medicine, Mater Children's Hospital, South Brisbane, Queensland, Australia.
J Paediatr Child Health. 1999 Feb;35(1):49-54. doi: 10.1046/j.1440-1754.1999.00336.x.
To examine the clinical and polysomnographic (PSG) profiles of neurologically normal and abnormal children with obstructive sleep apnoea (OSA) and explore the relationship between these profiles.
We enrolled 56 children with persistent snoring and OSA for the study, 16 of whom were neurologically abnormal. All children were examined clinically and attended an overnight PSG study. Total clinical scores, PSG scores, and mild/moderate or severe ratings were derived for each child.
Comparison of individual PSG parameters with neurological status demonstrated that the abnormal children had significantly increased obstructive apnoea indices, increased desaturation events and lower mean arousal indices compared to their neurologically normal OSA peers. For the neurologically abnormal children, there was a significant correlation between severity ratings of disease according to clinical and PSG profiles (r = 0.56, P = 0.03, sensitivity 82%) using the clinical summary as the gold standard, although the association was less marked in the neurologically normal children (r = -0.08, P = NS, sensitivity 69%).
Neurologically abnormal children are likely to have more severe abnormalities in selected polysomnographic indices and overall scores. However, the clinical assessment is only likely to reflect this at the severe end of the spectrum. These relationships are not seen in the neurologically normal child, where little or no reliance can be placed upon predicting the severity of the polysomnographic findings from the clinical data. Decisions regarding the severity of disease and treatment should be based on the combined findings of the clinical and PSG data rather than overall clinical and polysomnographic scores or selected clinical and polysomnographic parameters.
研究神经功能正常和异常的阻塞性睡眠呼吸暂停（OSA）儿童的临床和多导睡眠图（PSG）特征，并探讨这些特征之间的关系。
我们招募了56名患有持续性打鼾和OSA的儿童进行研究，其中16名神经功能异常。所有儿童均接受了临床检查并参加了夜间PSG检查。得出每个儿童的总临床评分、PSG评分以及轻度/中度或重度分级。
将个体PSG参数与神经状态进行比较显示，与神经功能正常的OSA儿童相比，神经功能异常的儿童阻塞性呼吸暂停指数显著增加，血氧饱和度下降事件增多，平均觉醒指数降低。对于神经功能异常的儿童，以临床总结为金标准，根据临床和PSG特征得出的疾病严重程度分级之间存在显著相关性（r = 0.56，P = 0.03，敏感性82%），尽管在神经功能正常的儿童中这种相关性不太明显（r = -0.08，P =无统计学意义，敏感性69%）。
神经功能异常的儿童在某些多导睡眠图指数和总体评分中可能存在更严重的异常。然而，临床评估可能仅在疾病严重程度范围内反映这一点。在神经功能正常的儿童中未观察到这些关系，无法根据临床数据预测多导睡眠图结果的严重程度。关于疾病严重程度和治疗的决策应基于临床和PSG数据的综合结果，而不是总体临床和多导睡眠图评分或选定的临床和多导睡眠图参数。
