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与囊性纤维化患儿睡眠氧合相关的因素。

Factors that correlate with sleep oxygenation in children with cystic fibrosis.

作者信息

Uyan Z S, Ozdemir N, Ersu R, Akpinar I, Keskin S, Cakir E, Karadağ B, Karakoç F, Dağli E

机构信息

Division of Pediatric Pulmonology, Marmara University, Istanbul, Turkey.

出版信息

Pediatr Pulmonol. 2007 Aug;42(8):716-22. doi: 10.1002/ppul.20643.

Abstract

OBJECTIVE

Cystic fibrosis (CF) patients may develop hypoxemia during sleep. Limited information is available on nocturnal oxygen saturation in CF children with less severe lung disease. The aim of this study was to investigate the degree of nocturnal oxygen desaturation and factors that correlate with nocturnal oxygenation in CF children with normal pulmonary function tests (PFTs) or mild to moderate lung disease.

METHOD

Awake resting and post-exercise SpO2 were measured by pulse oximetry. Each patient had overnight oximetry monitorization at home. Six minutes walk test (6MWT), Shwachman-Kulczycki (S-K), Brasfield and computed tomography (CT) scores, blood gas analysis and nutritional status of patients were evaluated.

RESULTS

Twenty-four patients with a median age of 9.5 years were included. Nocturnal mean SpO2 did not differ according to the severity of lung disease based on PFT. However, lowest SpO2 obtained was lower in children with both mild and moderate lung disease compared to normals (87.4% vs. 91.7%, respectively, p = 0.009). 95.8% of CF children with normal PFT or mild to moderate lung disease had desaturation events during sleep. Nocturnal mean SpO2 correlated with S-K (Spearman's rho = 0.64, p < 0.0001), Brasfield (Spearman's rho = 0.31, p = 0.007) and CT scores (Spearman's rho = -0.67, p < 0.0001) as well as PaO2 (Spearman's rho = 0.28, p = 0.021), SaO2 (Spearman's rho = 0.28, p = 0.023), z-score of weight (Spearman's rho = 0.23, p = 0.20) and height (Spearman's rho = 0.20, p = 0.30), there was no correlation with 6MWT.

CONCLUSIONS

In CF children with normal PFT or mild-to-moderate lung disease, nocturnal oxygenation may correlate with S-K, Brasfield and CT scores as well as PaO2, SaO2, z-score of weight and height.

摘要

目的

囊性纤维化(CF)患者在睡眠期间可能会出现低氧血症。关于肺部疾病不太严重的CF儿童夜间血氧饱和度的信息有限。本研究的目的是调查肺功能测试(PFT)正常或患有轻至中度肺部疾病的CF儿童夜间氧饱和度下降的程度以及与夜间氧合相关的因素。

方法

通过脉搏血氧饱和度测定法测量清醒静息和运动后的SpO₂。每位患者在家中进行夜间血氧饱和度监测。评估患者的六分钟步行试验(6MWT)、施瓦克曼-库尔奇茨基(S-K)评分、布拉斯菲尔德评分和计算机断层扫描(CT)评分、血气分析及营养状况。

结果

纳入了24名中位年龄为9.5岁的患者。根据基于PFT的肺部疾病严重程度,夜间平均SpO₂无差异。然而,与正常儿童相比,患有轻度和中度肺部疾病的儿童获得的最低SpO₂较低(分别为87.4%对91.7%,p = 0.009)。95.8%的PFT正常或患有轻至中度肺部疾病的CF儿童在睡眠期间出现氧饱和度下降事件。夜间平均SpO₂与S-K评分(斯皮尔曼等级相关系数rho = 0.64,p < 0.0001)、布拉斯菲尔德评分(斯皮尔曼等级相关系数rho = 0.31,p = 0.007)和CT评分(斯皮尔曼等级相关系数rho = -0.67,p < 0.0001)以及PaO₂(斯皮尔曼等级相关系数rho = 0.28,p = 0.021)、SaO₂(斯皮尔曼等级相关系数rho = 0.28,p = 0.023)、体重z评分(斯皮尔曼等级相关系数rho = 0.23,p = 0.20)和身高z评分(斯皮尔曼等级相关系数rho = 0.20,p = 0.30)相关,与6MWT无关。

结论

在PFT正常或患有轻至中度肺部疾病的CF儿童中,夜间氧合可能与S-K评分、布拉斯菲尔德评分和CT评分以及PaO₂、SaO₂、体重z评分和身高z评分相关。

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