Ungkanont Kitirat, Areyasathidmon Suththipol
Department of Otolaryngology, Faculty of Medicine Siriraj Hospital, Bangkok 10700, Thailand.
Int J Pediatr Otorhinolaryngol. 2006 Nov;70(11):1945-8. doi: 10.1016/j.ijporl.2006.07.006. Epub 2006 Aug 30.
To determine the relationship between causative factors of sleep-disordered breathing (SDB) and quality of life (QOL) of children who presented with SDB.
Prospective cross-sectional study was done. Pediatric outpatients with SDB were recruited. Patients with craniofacial, neurologic or syndromic anomalies and previous adenotonsillectomy were excluded. Data collected were clinical history, physical examination and lateral skull X-ray, along with QOL survey by using obstructive sleep apnea-18 (OSA-18) questionnaires. We assessed the association between clinical signs, the size of the tonsils and the adenoids, overweight/obesity and the OSA-18 scores to see the impact of these factors on QOL.
Fifty-one children were enrolled. Mean age was 6.4+/-2.6 years. The most common clinical findings was mouth breathing (41.2%). Tonsillar hypertrophy (> or =3+) was found in 62.7 and 52.9% had adenoid-nasopharyngeal ratio greater than 70%. Overweight/obesity were found in 35.3% of the patients. OSA-18 scores ranged from 22 to 85. Tonsillar hypertrophy was significantly related to QOL (p<0.05). Adenoid hypertrophy had trends towards impact on QOL (p=0.094). Mouth breathing correlated well with QOL (p<0.01). Overweight/obesity and QOL had no statistically significant correlation.
Tonsillar hypertrophy and mouth breathing were the clinical findings that affected most to the QOL of the children with SDB. Adenoid hypertrophy had trends towards the impact on QOL, although not statistically significant.
确定睡眠呼吸障碍(SDB)的致病因素与患有SDB的儿童生活质量(QOL)之间的关系。
进行前瞻性横断面研究。招募患有SDB的儿科门诊患者。排除患有颅面、神经或综合征异常以及既往有腺样体扁桃体切除术的患者。收集的数据包括临床病史、体格检查和头颅侧位X线片,以及使用阻塞性睡眠呼吸暂停-18(OSA-18)问卷进行的生活质量调查。我们评估了临床体征、扁桃体和腺样体大小、超重/肥胖与OSA-18评分之间的关联,以观察这些因素对生活质量的影响。
共纳入51名儿童。平均年龄为6.4±2.6岁。最常见的临床发现是张口呼吸(41.2%)。62.7%的患儿存在扁桃体肥大(≥3度),52.9%的患儿腺样体-鼻咽比例大于70%。35.3%的患者存在超重/肥胖。OSA-18评分范围为22至85分。扁桃体肥大与生活质量显著相关(p<0.05)。腺样体肥大对生活质量有影响趋势(p=0.094)。张口呼吸与生活质量密切相关(p<0.01)。超重/肥胖与生活质量无统计学显著相关性。
扁桃体肥大和张口呼吸是对患有SDB的儿童生活质量影响最大的临床发现。腺样体肥大对生活质量有影响趋势,尽管无统计学显著性。