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阻塞性睡眠呼吸暂停和原发性打鼾儿童的动态血压监测

Ambulatory blood pressure monitoring in children with obstructive sleep apnea and primary snoring.

作者信息

Weber Silke Anna Theresa, Santos Victor José Barbosa dos, Semenzati Graziela de Oliveira, Martin Luis Cuadrado

机构信息

Ophthalmology, Otorhinolaryngology and Head & Neck Surgery Department, Botucatu School of Medicine-São Paulo State University, Botucatu, SP, Brazil.

出版信息

Int J Pediatr Otorhinolaryngol. 2012 Jun;76(6):787-90. doi: 10.1016/j.ijporl.2012.02.041. Epub 2012 Mar 18.

Abstract

OBJECTIVE

To evaluate the systemic blood pressure (BP) during daytime and nighttime in children with sleep breathing disorders (SBD) and compare parameters of BP in children with diagnosis of obstructive sleep apnea syndrome (OSA) to those one with primary snoring (PS).

METHODS

Children, both genders, aged from 8 to 12 years, with symptoms of SBD realized an overnight polysomnography followed by a 24h recording of ambulatory BP.

RESULTS

All subjects presented with a history of snoring 7 nights per week. Children who have apnea/hipoapnea index ≥ four or a apnea index ≥ one presented a mean BP of 93±7mmHg and 85±9mmHg diurnal and nocturnal respectively whereas children who have a apnea/hipoapnea < four or a apnea index < one presented 90±7mmHg and 77±2mmHg. Eight children out of fourteen, from OSA group, lost the physiologic nocturnal dipping of the blood pressure. Among OSA children 57% were considered non-dippers. Two (16%) have presented absence of nocturnal dipping among children with primary snoring. The possibility of OSA children loosing physiologic blood pressure dipping was 6.66 higher than the possibilities of patients from PS group.

DISCUSSION

Our results indicate that children with sleep apnea syndrome exhibit a higher 24h blood pressure when compared with those of primary snoring in form of decreased degree of nocturnal dipping and increased levels of diastolic and mean blood pressure, according to previous studies in literature. OSA in children seems to be associated to the development of hypertension or other cardiovascular disease.

摘要

目的

评估睡眠呼吸障碍(SBD)儿童白天和夜间的系统血压(BP),并比较诊断为阻塞性睡眠呼吸暂停综合征(OSA)的儿童与原发性打鼾(PS)儿童的血压参数。

方法

年龄在8至12岁、有SBD症状的儿童接受夜间多导睡眠监测,随后进行24小时动态血压记录。

结果

所有受试者均有每周7晚打鼾史。呼吸暂停/低通气指数≥4或呼吸暂停指数≥1的儿童白天和夜间平均血压分别为93±7mmHg和85±9mmHg,而呼吸暂停/低通气指数<4或呼吸暂停指数<1的儿童白天和夜间平均血压分别为90±7mmHg和77±2mmHg。OSA组14名儿童中有8名失去了生理性夜间血压下降。在OSA儿童中,57%被认为是非勺型血压。原发性打鼾儿童中有2名(16%)出现夜间血压无下降情况。OSA儿童失去生理性血压下降的可能性比PS组患者高6.66倍。

讨论

我们的结果表明,根据文献中的先前研究,与原发性打鼾儿童相比,睡眠呼吸暂停综合征儿童24小时血压更高,表现为夜间血压下降程度降低以及舒张压和平均血压水平升高。儿童OSA似乎与高血压或其他心血管疾病的发生有关。

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