Johns Hopkins Department of Otolaryngology-Head and Neck Surgery, Baltimore, MD 21287, USA.
Int Forum Allergy Rhinol. 2013 Jun;3(6):504-9. doi: 10.1002/alr.21123. Epub 2013 Jan 10.
The objective of this work was to systematically review existing literature on the association between allergic rhinitis (AR) and sleep-disordered breathing (SDB) in children.
We performed a literature search encompassing the last 25 years in PubMed, EMBASE, and Cochrane CENTRAL. Inclusion criteria included English-language papers containing original human data, number of subjects ≥7, and age <18 years old. Data was systematically collected on study design, patient demographics, clinical characteristics/outcomes, and level-of-evidence. Two investigators independently reviewed all articles.
The initial search yielded 433 abstracts, of which 18 articles were included. Twelve (67%) of the 18 articles showed a statistically significant association between AR and SDB. All articles were either case-series or case-control studies. Based on the Newcastle-Ottawa scale, the quality of the articles was determined to be fair to good. For characterizing AR, 7 (39%) studies included skin-prick testing and/or in vitro testing. For determining presence of SDB, 7 (39%) of the studies used polysomnographic data, of which 1 study incorporated data from a home polysomnogram. Habitual snoring was the most common form of SDB studied, in 10 (56%) of the articles. Obstructive sleep apnea was studied in 6 (33%) articles.
Although the majority of the studies included in this review showed a significant association between AR and SDB, all of the studies were evidence level 3b and 4, for an overall grade of B- evidence (Oxford Evidence-Based Medicine Center). Further higher-quality studies should be performed in the future to better evaluate the relationship between AR and SDB in children.
本研究旨在系统回顾现有文献，探讨儿童变应性鼻炎（AR）与睡眠呼吸障碍（SDB）之间的相关性。
我们在 PubMed、EMBASE 和 Cochrane CENTRAL 数据库中检索了过去 25 年的文献。纳入标准为包含原始人类数据、患者例数≥7 例、年龄<18 岁的英文文献。系统性收集研究设计、患者人口统计学、临床特征/结局和证据水平等数据。两名研究者独立对所有文章进行了评估。
最初的检索得到 433 篇摘要，其中 18 篇文章被纳入。18 篇文章中有 12 篇（67%）显示 AR 与 SDB 之间存在统计学显著相关性。所有文章均为病例系列或病例对照研究。基于 Newcastle-Ottawa 量表，文章质量被评定为中等偏上。为了明确 AR 的特征，7 项（39%）研究纳入了皮肤点刺试验和/或体外检测。为了确定 SDB 的存在，7 项（39%）研究使用了多导睡眠图数据，其中 1 项研究纳入了家庭多导睡眠图数据。习惯性打鼾是研究中最常见的 SDB 形式，10 项（56%）研究中有此表现。阻塞性睡眠呼吸暂停在 6 项（33%）研究中被研究。
尽管本综述中纳入的大多数研究显示 AR 与 SDB 之间存在显著相关性，但所有研究的证据水平均为 3b 和 4 级，总体证据等级为 B-（牛津循证医学中心）。未来应开展更多高质量的研究，以更好地评估儿童 AR 与 SDB 之间的关系。
