Martinelli Eli O, Haddad Fernanda Louise M, Stefanini Renato, Moreira Gustavo A, Rapoport Priscila B, Gregório Luis Carlos, Tufik Sérgio, Bittencourt Lia Rita A
Universidade Federal de São Paulo.
Sleep Sci. 2017 Jan-Mar;10(1):1-6. doi: 10.5935/1984-0063.20170001.
Obesity is a factor that is strongly related to the occurrence of obstructive sleep apnea (OSA) in adults, although this association remains controversial for children.
The aim of this study was to compare the clinical and upper airway charactheristics, obtained by questionnaires, physical examination and laboratory tests, among obese children with and without OSA.
This was aprospective cohort study. 44 obese children (body mass index above the 95th percentile) were included in the study. Questionnaires, physical examination of the upper airway, nasofibrolaryngoscopy, polysomnography, and laboratory allergic tests were performed.
There were 22 male patients (50%), and the mean age was 7.6±2.5 years. OSA was present in 19 (43%) patients. There were no statistically significant differences between the groups with and without OSA, in relation to clinical or laboratory allergic parameters. For the upper airway assessments, hypertrophy of the pharyngeal (p=0.001) and palatine (p=0.049) tonsils were the only parameters associated with OSA, and a modified Mallampati index of class III/IV also demonstrated a tendency towards being statistically associated with OSA (p=0.081). Moreover, these findings were confirmed to be factors associated with OSA in this group of children according to a logistic regression analysis.
The occurrence rate of OSA in this obese pediatric population was high. Adenotonsillar hypertrophy and a modified Mallampati index of class III/IV were the factors associated with OSA.
肥胖是与成人阻塞性睡眠呼吸暂停(OSA)的发生密切相关的一个因素,尽管这种关联在儿童中仍存在争议。
本研究的目的是比较通过问卷调查、体格检查和实验室检查获得的有或无OSA的肥胖儿童的临床和上气道特征。
这是一项前瞻性队列研究。44名肥胖儿童(体重指数高于第95百分位数)被纳入研究。进行了问卷调查、上气道体格检查、鼻纤维喉镜检查、多导睡眠图检查和实验室过敏试验。
有22例男性患者(50%),平均年龄为7.6±2.5岁。19例(43%)患者存在OSA。在临床或实验室过敏参数方面,有或无OSA的两组之间没有统计学上的显著差异。在上气道评估中,咽扁桃体(p=0.001)和腭扁桃体(p=0.049)肥大是与OSA相关的唯一参数,改良的马兰帕蒂分级III/IV级也显示出与OSA有统计学关联的趋势(p=0.081)。此外,根据逻辑回归分析,这些发现被证实是该组儿童中与OSA相关的因素。
在这个肥胖儿童群体中OSA的发生率很高。腺样体扁桃体肥大和改良的马兰帕蒂分级III/IV级是与OSA相关的因素。