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儿童哮喘和变应性鼻炎与睡眠呼吸障碍的关联

Association of Asthma and Allergic Rhinitis With Sleep-Disordered Breathing in Childhood.

作者信息

Perikleous Evanthia, Steiropoulos Paschalis, Nena Evangelia, Iordanidou Maria, Tzouvelekis Argyrios, Chatzimichael Athanasios, Paraskakis Emmanouil

机构信息

Master Program in Sleep Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.

Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.

出版信息

Front Pediatr. 2018 Sep 11;6:250. doi: 10.3389/fped.2018.00250. eCollection 2018.

Abstract

Asthma and allergic rhinitis (AR) are the most common chronic conditions in childhood and have previously been linked to sleep-related breathing disorder (SRBD). Aim of the study was to examine the association between SRBD risk and asthma control in children with asthma and with or without AR. The assessment of FeNO and pulmonary function tests were performed in 140 children (65 with asthma, 57 with both asthma, and AR, 18 with only AR). Children with asthma completed the childhood Asthma Control Test (c-ACT), and the Sleep-Related Breathing Disorder scale, extracted from the Pediatric Sleep Questionnaire (PSQ). C-ACT scores ≤ 19 are indicative of poor asthma control whereas SRBD from PSQ scores ≥ 0.33 are suggestive of high risk for SRBD. Mean age ± SD was 7.8 ± 3.1 years. Mean PSQ ± SD and c-ACT ± SD scores were 0.17 ± 0.14 and 24.9 ± 3.2, respectively. High risk for SRBD was identified in 26 children. Children at high risk for SRBD had significantly decreased c-ACT score ( = 0.048), verified by a negative association between c-ACT and PSQ-SRBD scores ( = -0.356, < 0.001). Additionally a difference in diagnosis distribution between children at high or low risk for SRBD was observed. More specifically, among children at high risk, 88.5% were diagnosed with both atopic conditions, while this percentage among children at low risk was 29.8%. Asthma was mainly diagnosed in the latter group ( < 0.001). Poor asthma control is associated with SRBD. The presence of AR in children with asthma seems to increase the prevalence of SRBD in that particular population, requiring further investigation toward this direction.

摘要

哮喘和变应性鼻炎(AR)是儿童期最常见的慢性疾病,此前已被认为与睡眠相关呼吸障碍(SRBD)有关。本研究的目的是探讨患有哮喘且有或无AR的儿童中SRBD风险与哮喘控制之间的关联。对140名儿童(65名患有哮喘,57名同时患有哮喘和AR,18名仅患有AR)进行了呼出气一氧化氮(FeNO)评估和肺功能测试。患有哮喘的儿童完成了儿童哮喘控制测试(c-ACT)以及从儿童睡眠问卷(PSQ)中提取的睡眠相关呼吸障碍量表。c-ACT评分≤19表明哮喘控制不佳,而PSQ评分≥0.33提示SRBD风险高。平均年龄±标准差为7.8±3.1岁。平均PSQ±标准差和c-ACT±标准差评分分别为0.17±0.14和24.9±3.2。26名儿童被确定为SRBD高风险。SRBD高风险儿童的c-ACT评分显著降低(P = 0.048),c-ACT与PSQ-SRBD评分之间的负相关证实了这一点(r = -0.356,P < 0.001)。此外,观察到SRBD高风险或低风险儿童之间的诊断分布存在差异。更具体地说,在高风险儿童中,88.5%被诊断患有两种特应性疾病,而在低风险儿童中这一比例为29.8%。哮喘主要在后者组中被诊断出来(P < 0.001)。哮喘控制不佳与SRBD相关。哮喘儿童中AR的存在似乎增加了该特定人群中SRBD的患病率,需要朝着这个方向进行进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a846/6141753/91c8606c4798/fped-06-00250-g0001.jpg

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