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重度肥胖儿童的肺功能与睡眠相关呼吸障碍

Pulmonary function and sleep-related breathing disorders in severely obese children.

作者信息

Dubern Beatrice, Tounian Patrick, Medjadhi Noria, Maingot Lucia, Girardet Jean-Philippe, Boulé Michéle

机构信息

Armand-Trousseau Teaching Hospital, Department of Pediatric Gastroenterology and Nutrition, Avenue du Dr Arnold Netter, Paris, France.

出版信息

Clin Nutr. 2006 Oct;25(5):803-9. doi: 10.1016/j.clnu.2005.12.001. Epub 2006 May 15.

Abstract

BACKGROUND & AIMS: To evaluate the frequency of pulmonary function and sleep-breathing disorders in severely obese children and to search for their association with obesity phenotypes.

METHODS

Sleep studies and spirometry were performed for 54 severely obese children.

RESULTS

Upper airway resistances (RAWs) were increased with RAW>200% and forced 25s expiratory volume<80% in 83% and 60% of individuals, respectively. A decrease in functional residual capacity (FRC)<80% was found in 43%. Fifty-two percent of the children had a desaturation index>10 during sleep, and 41% of children presented at least one of three severity criteria (snoring index>300 per hour, respiratory events index (REI)>10 and arousal index>10). Univariate analyses showed a positive correlation between snoring index and BMI Z-score and neck/height ratio (P=0.01 and 0.04, respectively) as between REI and the same parameters (P=0.01 and 0.03, respectively). In a multivariate model with BMI Z-score, NHR still correlated with the snoring index (P=0.02) and REI (P=0.01).

CONCLUSIONS

In our cohort, obese children showed frequent pulmonary function and sleep-breathing disorders. The later were associated with impaired upper airway respiratory conductance.

摘要

背景与目的

评估重度肥胖儿童肺功能和睡眠呼吸障碍的发生率,并探寻其与肥胖表型的关联。

方法

对54名重度肥胖儿童进行睡眠研究和肺活量测定。

结果

分别有83%和60%的个体上气道阻力(RAW)增加(RAW>200%)且用力呼气25秒容积<80%。43%的个体功能残气量(FRC)降低<80%。52%的儿童睡眠期间的血氧饱和度下降指数>10,41%的儿童至少符合三项严重程度标准中的一项(打鼾指数>300次/小时、呼吸事件指数(REI)>10和觉醒指数>10)。单因素分析显示,打鼾指数与BMI Z评分和颈/身高比值呈正相关(P分别为0.01和0.04),REI与相同参数也呈正相关(P分别为0.01和0.03)。在包含BMI Z评分的多变量模型中,颈/身高比值仍与打鼾指数(P=0.02)和REI(P=0.01)相关。

结论

在我们的队列中,肥胖儿童常出现肺功能和睡眠呼吸障碍。后者与上气道呼吸传导受损有关。

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