Alexopoulos Emmanouel I, Kaditis Athanasios G, Kalampouka Efthimia, Kostadima Eleni, Angelopoulos Nikiforos V, Mikraki Vasiliki, Skenteris Nikolaos, Gourgoulianis Konstantinos
Department of Pediatrics, University of Thessaly School of Medicine, Larissa, Greece.
Pediatr Pulmonol. 2004 Aug;38(2):161-7. doi: 10.1002/ppul.20079.
Nasal corticosteroids improve polysomnography indices but not symptoms in children with mild to moderate sleep-disordered breathing. We hypothesized that administration of nasal corticosteroids for 4 weeks to snoring children with only mild elevation in their apnea-hypopnea index would improve both polysomnography findings and symptoms of sleep-disordered breathing. Budesonide 50 mcg per nostril twice daily was administered for 4 weeks to children (2-14 years old) with habitual snoring and an apnea-hypopnea index of 1-10 episodes/hr. Subjects were evaluated before treatment and at 2 weeks and 9 months after its completion. Primary outcome variables were changes in apnea-hypopnea index and symptom score. Twenty-seven children were studied. At 2 weeks, the mean apnea-hypopnea index decreased from 5.2 (+/-2.2) episodes/hr to 3.2 (+/-1.5) episodes/hr, and median oxygen desaturation of hemoglobin index fell from 3.1 (0.4-8.2) to 1.9 (0.2-5.4) (P < 0.0001). Mean symptom score was 1.33 (+/-2.11) at baseline, and decreased to -0.008 (+/-2.24) at 2 weeks after treatment and to -1.08 (+/-1.75) at 9 months after treatment (P < 0.05). Four weeks of nasal budesonide improved both polysomnography findings and symptoms in children with mild sleep-disordered breathing. The clinical effect is maintained for several months after treatment.
鼻用皮质类固醇可改善轻至中度睡眠呼吸障碍儿童的多导睡眠图指标，但不能改善症状。我们假设，对呼吸暂停低通气指数仅轻度升高的打鼾儿童给予4周鼻用皮质类固醇治疗，将改善多导睡眠图检查结果和睡眠呼吸障碍症状。对2-14岁习惯性打鼾且呼吸暂停低通气指数为1-10次/小时的儿童，每侧鼻孔每日两次给予50微克布地奈德，持续4周。在治疗前以及治疗结束后2周和9个月对受试者进行评估。主要结局变量为呼吸暂停低通气指数和症状评分的变化。共研究了27名儿童。在2周时，平均呼吸暂停低通气指数从5.2（±2.2）次/小时降至3.2（±1.5）次/小时，血红蛋白氧饱和度指数中位数从3.1（0.4-8.2）降至1.9（0.2-5.4）（P<0.0001）。基线时平均症状评分为1.33（±2.11），治疗后2周降至-0.008（±2.24），治疗后9个月降至-1.08（±1.75）（P<0.05）。4周的鼻用布地奈德治疗改善了轻度睡眠呼吸障碍儿童的多导睡眠图检查结果和症状。治疗后临床效果可维持数月。
