Park Do-Yang, Choi Ji Ho, Kang So Young, Han Jinjoo, Park Hun Yi, Hwang Jin Soon, Cho Jae Ho, Cho Min Hyuk, Kim Hyun Jun
Department of Otolaryngology, Ajou University School of Medicine, Suwon, Republic of Korea; Department of Medicine, Graduate School, Yonsei University, Seoul, Republic of Korea.
Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea.
Int J Pediatr Otorhinolaryngol. 2018 Mar;106:41-45. doi: 10.1016/j.ijporl.2018.01.001. Epub 2018 Jan 8.
Pediatric obstructive sleep apnea has a relatively high prevalence and has various negative health and behavioral consequences. Among the various complications of pediatric obstructive sleep apnea, growth disturbance is still controversial.
745 pediatric subjects with obstructive sleep apnea diagnosed by in-lab polysomnography were enrolled, after excluding ineligible subjects with abnormal growth related factors. Height, weight, and BMI of enrolled patients were measured and statistically converted to z-scores, and the converted data were analyzed statistically with the polysomnographic results. Multiple linear regression were used to analyze the relationships between age, gender, z-score for weight, polysomnography results, and z-score for height.
Patients with higher respiratory related index or lower mean/lowest oxygen saturation of PSG showed smaller z-score for height. Mean apnea hypopnea index and standard deviation of enrolled patients was 7.46 ± 12.92, with moderate severity. And mean z-score for height and standard deviation was 0.21 ± 1.15. Apnea hypopnea index, respiratory disturbance index, obstructive apnea index, and hypopnea index, respiratory related results of polysomnography, were statistically negative correlated with a z-score for height. And mean oxygen saturation and lowest oxygen saturation, oxygen saturation results of polysomnography, were statistically positive correlated with a z-score for height.
Respiratory related results and oxygen saturation results of polysomnography show negative and positive correlation with z-score for height. Therefore, pediatric obstructive sleep apnea have a negative effect on longitudinal growth.
小儿阻塞性睡眠呼吸暂停患病率相对较高，会对健康和行为产生多种负面后果。在小儿阻塞性睡眠呼吸暂停的各种并发症中，生长发育障碍仍存在争议。
纳入745例经实验室多导睡眠图诊断为阻塞性睡眠呼吸暂停的小儿受试者，排除有生长相关因素异常的不合格受试者。测量入选患者的身高、体重和BMI，并进行统计学转换为z评分，将转换后的数据与多导睡眠图结果进行统计学分析。采用多元线性回归分析年龄、性别、体重z评分、多导睡眠图结果和身高z评分之间的关系。
呼吸相关指数较高或多导睡眠图平均/最低氧饱和度较低的患者身高z评分较小。入选患者的平均呼吸暂停低通气指数和标准差为7.46±12.92，为中度严重程度。身高的平均z评分和标准差为0.21±1.15。多导睡眠图的呼吸暂停低通气指数、呼吸紊乱指数、阻塞性呼吸暂停指数和低通气指数等呼吸相关结果与身高z评分呈负相关。多导睡眠图的平均氧饱和度和最低氧饱和度等氧饱和度结果与身高z评分呈正相关。
多导睡眠图的呼吸相关结果和氧饱和度结果与身高z评分呈负相关和正相关。因此，小儿阻塞性睡眠呼吸暂停对纵向生长有负面影响。
