睡眠呼吸紊乱与儿童哮喘:临床意义。
Sleep-disordered breathing and childhood asthma: clinical implications.
机构信息
Pediatric Pulmonology, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
出版信息
Curr Opin Pulm Med. 2013 Jan;19(1):79-83. doi: 10.1097/MCP.0b013e32835b11a1.
PURPOSE OF REVIEW
Asthma morbidity in children remains high despite comprehensive evidence-based guidelines for evaluation and treatment. The objective of this review is to examine the evidence that obstructive sleep-disordered breathing often co-exists with asthma and is associated with asthma severity, and to discuss the clinical implications of this relationship, focusing particularly on studies published within the past year.
RECENT FINDINGS
Obstructive sleep-disordered breathing is highly prevalent in children with severe or poorly controlled asthma. Data from an observational study suggest that adenotonsillectomy markedly improves asthma outcomes in children with poorly controlled asthma and comorbid obstructive sleep apnea.
SUMMARY
Clinicians should consider evaluating and treating obstructive sleep-disordered breathing in children with severe or difficult-to-control asthma. Further controlled studies are needed to confirm that treatment of obstructive sleep apnea improves pediatric asthma outcomes, and to extend our understanding of how asthma and sleep-disordered breathing interact.
目的综述
尽管有针对评估和治疗的全面循证指南,儿童哮喘发病率仍居高不下。本综述的目的是研究阻塞性睡眠呼吸障碍疾病常与哮喘共存并与哮喘严重程度相关的证据,并讨论这种关系的临床意义,特别关注在过去一年中发表的研究。
最近的发现
阻塞性睡眠呼吸障碍疾病在严重或控制不佳的哮喘儿童中非常普遍。一项观察性研究的数据表明,腺样体扁桃体切除术可显著改善控制不佳的哮喘和合并阻塞性睡眠呼吸暂停的儿童的哮喘结局。
总结
临床医生应考虑在严重或难以控制的哮喘儿童中评估和治疗阻塞性睡眠呼吸障碍疾病。需要进一步的对照研究来证实治疗阻塞性睡眠呼吸暂停可改善儿科哮喘结局,并扩展我们对哮喘和睡眠呼吸障碍疾病相互作用的理解。