Kwok Ka-li, Ng Daniel K, Chan Chung-hong
Department of Paediatrics, Kwong Wah Hospital, Hong Kong SAR, China.
Ann Acad Med Singap. 2008 Aug;37(8):715-21.
Adults with obstructive sleep apnoea (OSA) are well documented to be at high risk for cardiovascular abnormalities. Growing evidence suggests that OSA is also associated with cardiovascular consequences in children. The purpose of this review is to examine the available data on this association in children.
Primary studies were extracted from a MEDLINE search limited to those published between 1970 and 2008. The keywords used included child, sleep disordered breathing, sleep apnoea, snoring, blood pressure and hearts. The relevant articles were selected by consensus between 2 authors.
The results suggested that OSA was consistently associated with hypertension. Meta-analysis of risk of hypertension in those with high apnoea-hypopnoea index was undertaken. A combined odds ratio equal to 3.15 was found (95% confidence interval, 2.01 to 4.93). There was evidence for increased sympathetic activation, decreased arterial distensibility and ventricular hypertrophy in children with OSA.
Childhood OSA is associated with blood pressure dysregulation. The association of OSA with other cardiovascular morbidities requires further study in view of the limited data available currently.
有充分文献记载，患有阻塞性睡眠呼吸暂停（OSA）的成年人存在心血管异常的高风险。越来越多的证据表明，OSA在儿童中也与心血管疾病相关。本综述的目的是研究关于儿童中这种关联的现有数据。
从MEDLINE检索中提取主要研究，检索限于1970年至2008年发表的文献。使用的关键词包括儿童、睡眠呼吸紊乱、睡眠呼吸暂停、打鼾、血压和心脏。相关文章由两位作者协商选定。
结果表明，OSA始终与高血压相关。对呼吸暂停低通气指数高的患者发生高血压的风险进行了荟萃分析。发现合并比值比等于3.15（95%置信区间，2.01至4.93）。有证据表明，患有OSA的儿童交感神经激活增加、动脉弹性降低和心室肥厚。
儿童OSA与血压调节异常相关。鉴于目前可用数据有限，OSA与其他心血管疾病的关联需要进一步研究。
