Duke J C, Sekar K C, Toubas P L, McCaffree M A
Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City 73190.
J Perinatol. 1992 Jun;12(2):124-8.
Infants experiencing apparent life-threatening events (ALTE) have been reported to have elevated frequencies of periodic breathing and obstructive apnea when compared to presumably normal control groups. Whether these characteristics extend to the siblings of ALTE infants remains unknown. This study compared, retrospectively, the apnea indices of 13 first-born infants experiencing an ALTE with their subsequent asymptomatic siblings who had undergone polygraphic sleep apnea evaluations (including electrocardiogram, chest wall movements, expired CO2, and transcutaneous pulse oximetry). Gestation, birthweight, age at study, apnea and periodic breathing indices, and oxygen desaturations were compared. Regression analyses revealed that adjustments for gestational and postnatal age eliminated differences in apnea indices. ALTE infants and their subsequent siblings experienced similar rates of apnea. Neither group had elevated rates of prolonged central apneas (greater than 10 seconds duration) or periodic breathing (greater than 5% sleep time). Neither group had subsequent severe apneas. The use of polygraphic study and cardiac/apnea monitors in subsequent siblings of ALTE are unnecessary and should be considered only when there is parental disagreement.
据报道，与推测为正常的对照组相比，经历明显危及生命事件（ALTE）的婴儿周期性呼吸和阻塞性呼吸暂停的频率更高。这些特征是否也适用于ALTE婴儿的兄弟姐妹尚不清楚。本研究回顾性比较了13名经历过ALTE的头胎婴儿与其随后接受多导睡眠呼吸暂停评估（包括心电图、胸壁运动、呼出二氧化碳和经皮脉搏血氧饱和度）的无症状兄弟姐妹的呼吸暂停指数。比较了妊娠情况、出生体重、研究时的年龄、呼吸暂停和周期性呼吸指数以及氧饱和度下降情况。回归分析显示，对孕周和出生后年龄进行调整后，呼吸暂停指数的差异消失。ALTE婴儿及其随后的兄弟姐妹经历呼吸暂停的发生率相似。两组中延长的中枢性呼吸暂停（持续时间超过10秒）或周期性呼吸（睡眠时间超过5%）的发生率均未升高。两组随后均未出现严重呼吸暂停。对于ALTE婴儿的后续兄弟姐妹，使用多导睡眠监测和心脏/呼吸暂停监测仪是不必要的，只有在父母意见不一致时才应考虑使用。
