Kitamura Takuro, Miyazaki Soichiro, Kobayashi Ryuichi, Kadotani Hiroshi, Kanemura Takashi, Komada Ichiro, Nishikawa Michiko, Okawa Masako, Koizumi Hiroki, Takeuchi Shoko, Suzuki Hideaki
a Department of Otorhinolaryngology-Head and Neck Surgery , University of Occupational and Environmental Health , Kitakyushu , Japan ;
b Department of Sleep Medicine , Shiga University of Medical Science , Otsu , Japan ;
Acta Otolaryngol. 2016 Jun;136(6):606-12. doi: 10.3109/00016489.2016.1144144. Epub 2016 Feb 22.
Conclusions The prevalence of obstructive sleep apnea (OSA) in preschool-aged children diagnosed by the International Classification of Sleep Disorders (ICSD) version 3 criteria was relatively higher than that diagnosed by ICSD-2. Although the assessment of the upper airway by lateral neck radiography was effective for detecting OSA in this age group, this assessment is not recommended for all children as a screening method because of parental concern related to radiation exposure. Objective This study investigated the prevalence of OSA and the screening capacity of lateral neck radiography in community-based preschool-aged children. Methods Parents of 211 children aged 3-6 years were requested to complete the sleep-related questionnaire. Subjects who agreed to further investigations were invited to undergo home type 3 portable monitoring and clinical examination, including radiography. We estimated the prevalence of OSA and evaluated the detection power of radiography for predicting OSA. Results One hundred and eighty-eight (89.1%) subjects completed the questionnaire and 67 (31.8%) agreed to further examinations. The weighted prevalence was 7.3% and 12.8% by ICSD-2 and 3, respectively. Area under the receiver operator curve for the adenoidal/nasopharyngeal and tonsil/pharyngeal ratios measured using radiography was slightly larger than that for tonsil size graded by visual inspection.
结论 根据《国际睡眠障碍分类》（ICSD）第3版标准诊断的学龄前儿童阻塞性睡眠呼吸暂停（OSA）患病率相对高于ICSD-2标准诊断的患病率。尽管通过颈部侧位X线片对上气道进行评估对于检测该年龄组的OSA有效，但由于家长对辐射暴露的担忧，不建议将此评估作为所有儿童的筛查方法。目的 本研究调查了社区学龄前儿童中OSA的患病率以及颈部侧位X线片的筛查能力。方法 要求211名3至6岁儿童的家长完成与睡眠相关的问卷。同意进一步检查的受试者被邀请进行家庭型3便携式监测和临床检查，包括X线摄影。我们估计了OSA的患病率，并评估了X线摄影预测OSA的检测能力。结果 188名（89.1%）受试者完成了问卷，67名（31.8%）同意进一步检查。根据ICSD-2和ICSD-3标准，加权患病率分别为7.3%和12.8%。使用X线摄影测量的腺样体/鼻咽部和扁桃体/咽部比例的受试者操作特征曲线下面积略大于通过视觉检查分级的扁桃体大小的曲线下面积。
