Kwok Ka Li, Ng Daniel K K, Cheung Yiu Fai
Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Grantham Hospital, The University of Hong Kong, Aberdeen, People's Republic of China.
Chest. 2003 May;123(5):1561-6. doi: 10.1378/chest.123.5.1561.
While previous studies have suggested an association between obstructive sleep apnea and cardiovascular complications, the effects of primary snoring in children on daytime systemic BP and arterial distensibility remain unknown.
To determine the effects of primary snoring on BP and peripheral conduit artery distensibility, 30 children with primary snoring were studied at an age of 9.5 +/- 2.8 years (mean +/- SD). Systemic BP was measured using an automated device, while brachioradial arterial distensibility was assessed by measuring pulse wave velocity (PWV), which is inversely related to the square root of distensibility. The results were compared to those of 30 healthy control subjects matched for age, sex, and body size.
As compared to control subjects, children with primary snoring had significantly higher systolic BP (112 +/- 10 mm Hg vs 105 +/- 8 mm Hg, p = 0.001), diastolic BP (60 +/- 7 mm Hg vs 53 +/- 9 mm Hg, p = 0.004), and mean BP (81 +/- 7 mm Hg vs 71 +/- 8 mm Hg, p < 0.001). Likewise, those with primary snoring had significantly higher PWV (9.7 +/- 1.6 m/s vs 7.9 +/- 2.0 m/s, p = 0.001). Multiple regression identified age, body mass index (BMI), and primary snoring as significant determinants of systemic BP; however, primary snoring is the only significant determinant of PWV. Regardless of the BMI, systemic BP and PWV remained significantly higher in children with primary snoring.
Children with primary snoring have increased daytime systemic BP and reduced arterial distensibility, which may jeopardize long-term cardiovascular health.
虽然先前的研究表明阻塞性睡眠呼吸暂停与心血管并发症之间存在关联,但儿童原发性打鼾对日间全身血压和动脉弹性的影响仍不清楚。
为了确定原发性打鼾对血压和外周动脉弹性的影响,对30名原发性打鼾儿童进行了研究,他们的年龄为9.5±2.8岁(平均±标准差)。使用自动设备测量全身血压,同时通过测量脉搏波速度(PWV)评估肱桡动脉弹性,脉搏波速度与弹性的平方根成反比。将结果与30名年龄、性别和体型相匹配的健康对照受试者的结果进行比较。
与对照受试者相比,原发性打鼾儿童的收缩压(112±10毫米汞柱对105±8毫米汞柱,p = 0.001)、舒张压(60±7毫米汞柱对53±9毫米汞柱,p = 0.004)和平均血压(81±7毫米汞柱对71±8毫米汞柱,p < 0.001)显著更高。同样,原发性打鼾儿童的脉搏波速度也显著更高(9.7±1.6米/秒对7.9±2.0米/秒,p = 0.001)。多元回归分析确定年龄、体重指数(BMI)和原发性打鼾是全身血压的重要决定因素;然而,原发性打鼾是脉搏波速度的唯一重要决定因素。无论BMI如何,原发性打鼾儿童的全身血压和脉搏波速度仍然显著更高。
原发性打鼾儿童的日间全身血压升高,动脉弹性降低,这可能会危及长期心血管健康。