Kasapkara Çiğdem Seher, Tümer Leyla, Aslan Ayşe Tana, Hasanoğlu Alev, Ezgü Fatih Süheyl, Küçükçongar Aynur, Tunca Zeynep, Köktürk Oğuz
Pediatric Metabolic Unit, Gazi University Hospital, Ankara, Turkey,
Sleep Breath. 2014 Mar;18(1):143-9. doi: 10.1007/s11325-013-0862-z. Epub 2013 May 22.
Mucopolysaccharidoses (MPS) are a group of inherited lysosomal storage disorders caused by the deficiency of hydrolases involved in the degradative pathway of glycosaminoglycans. In MPS, upper airway obstruction may result from multiple causative factors which may impact severely upon morbidity and mortality.
We evaluated upper airway obstructive disease and related clinical findings through home sleep study in 19 patients (11 with MPS VI, 4 with MPS I, 4 with MPS II) with MPS followed at Gazi University Pediatric Metabolic Unit. Patients underwent home-based sleep measurements, and sleep respiratory problems were asked in a detailed clinical history. Measurements of apnea, apnea-hypopnea index (AHI), hypopnea index, oxygen desaturation index, and minimal oxygen saturation were obtained through home sleep study.
For 19 children, the disorder was normal in 1, mild (AHI=1.5-5/h) in 5, moderate (AHI=5-10/h) in 2, and severe (AHI>10/h) in 11. The prevalence of OSA was 94.7 % (18/19) in patients with MPS. Snoring, witnessed apnea, pectus carinatum, and macroglossia were the main clinical findings. Echocardiograms showed evidence of pulmonary hypertension in 13 patients.
Home sleep study is a quick and accessible screening test to determine the abnormalities of breathing during sleep and enables clinicians to take necessary action for patients with severe manifestations.
黏多糖贮积症(MPS)是一组遗传性溶酶体贮积症,由参与糖胺聚糖降解途径的水解酶缺乏引起。在MPS中,上气道梗阻可能由多种致病因素导致,这可能严重影响发病率和死亡率。
我们通过家庭睡眠研究评估了加齐大学儿科代谢科随访的19例MPS患者(11例MPS VI型、4例MPS I型、4例MPS II型)的上气道阻塞性疾病及相关临床发现。患者接受了家庭睡眠测量,并在详细的临床病史中询问了睡眠呼吸问题。通过家庭睡眠研究获得了呼吸暂停、呼吸暂停低通气指数(AHI)、低通气指数、氧饱和度下降指数和最低氧饱和度的测量值。
19名儿童中,1名病情正常,5名轻度(AHI = 1.5 - 5/小时),2名中度(AHI = 5 - 10/小时),11名重度(AHI > 10/小时)。MPS患者中阻塞性睡眠呼吸暂停(OSA)的患病率为94.7%(18/19)。打鼾、目击性呼吸暂停、鸡胸和巨舌是主要临床发现。超声心动图显示13例患者有肺动脉高压迹象。
家庭睡眠研究是一种快速且可及的筛查测试,用于确定睡眠期间的呼吸异常,并使临床医生能够对有严重表现的患者采取必要措施。