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种族对儿童睡眠时上呼吸道动力功能的影响。

Effects of race on upper airway dynamic function during sleep in children.

机构信息

The Sleep Center and the 2Clinical and Translational Research Center, Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA 19104, USA.

出版信息

Sleep. 2011 Apr 1;34(4):495-501. doi: 10.1093/sleep/34.4.495.

Abstract

STUDY OBJECTIVE

Studies in adults and children have shown that African American race is a risk factor for the obstructive sleep apnea syndrome (OSAS). Therefore, we hypothesized that non-obese, non-snoring African American children would have a more collapsible upper airway during sleep than age-, gender-, and size-matched Caucasians.

DESIGN

Upper airway dynamic function was measured during sleep in normal African American and Caucasian children.

SETTING

Sleep laboratory.

PATIENTS OR PARTICIPANTS

56 normal children between the ages of 8-18 years.

INTERVENTIONS

Pressure-flow relationships were measured during NREM sleep. Nasal pressure was decreased to subatmospheric levels, using previously described techniques that resulted in an activated and relatively hypotonic upper airway.

MEASUREMENTS AND RESULTS

The activated and hypotonic critical pressures (Pcrit) were -25 (-25, -3) (median, range) and -19 (-25, -3) for African Americans, and -25 (-25, -4) and -25 (-25.0, -4) cm H(2)O, respectively, for Caucasians. The slopes of the pressure-flow response (SPF) under activated and hypotonic conditions for African Americans were 10 (-9, 46) and 13 (-20, 46), and for Caucasians 9 (-9, 64) and 8 (-5, 54) mL/s/cm H(2)O, respectively. There were no significant differences between groups for Pcrit or SPF under either activated or hypotonic conditions.

CONCLUSION

Upper airway collapsibility was similar in asymptomatic, non-obese African American and Caucasian children. Differences in upper airway characteristics and neuromotor function cannot explain the increased prevalence of OSAS in African American children.

摘要

研究对象

多项针对成人和儿童的研究表明,非裔美国人种是非阻塞性睡眠呼吸暂停综合征(OSAS)的一个风险因素。因此,我们假设,非肥胖、不打鼾的非裔美国儿童在睡眠期间其上气道的塌陷程度应弱于年龄、性别和体型相匹配的白种人。

设计

在正常非裔美国儿童和白种人儿童的睡眠期间测量其气道动态功能。

环境

睡眠实验室。

患者或参与者

56 名年龄在 8-18 岁之间的正常儿童。

干预措施

在 NREM 睡眠期间测量压力-流量关系。采用先前描述的技术使鼻腔压力降至亚大气压水平,导致上气道激活且相对低张。

测量和结果

非裔美国人的激活和低张临界压力(Pcrit)分别为-25(-25,-3)(中位数,范围)和-19(-25,-3)cmH2O,而白种人的分别为-25(-25,-4)和-25(-25.0,-4)cmH2O。在激活和低张条件下,非裔美国人的压力-流量反应斜率(SPF)分别为 10(-9,46)和 13(-20,46),而白种人的分别为 9(-9,64)和 8(-5,54)mL/s/cmH2O。在激活和低张条件下,两组间的 Pcrit 或 SPF 均无显著差异。

结论

无症状、非肥胖的非裔美国儿童和白种人儿童的上气道塌陷程度相似。上气道特征和神经运动功能的差异不能解释非裔美国儿童 OSAS 患病率增加的原因。

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