阻塞性肺疾病或睡眠呼吸紊乱儿童的夜间血氧测定。

Nocturnal oximetry in children with obstructive lung disease or sleep-disordered breathing.

机构信息

Division of Pediatric Pulmonology and Sleep Disorders Laboratory, First Department of Pediatrics, National and Kapodistrian University of Athens School of Medicine and Aghia Sophia Children's Hospital, Athens, Greece.

Cystic Fibrosis Center, Aghia Sophia Children's Hospital, Athens, Greece.

出版信息

Pediatr Pulmonol. 2019 May;54(5):551-556. doi: 10.1002/ppul.24259. Epub 2019 Jan 22.

DOI:10.1002/ppul.24259

PMID:30672145

Abstract

OBJECTIVES

Although progress has been made in the standardized interpretation of nocturnal oximetry in children with obstructive sleep-disordered breathing (SDB), no evidence exists on oximetry abnormalities in other respiratory disorders. We aimed to compare obstructive lung disease (OLD) and SDB regarding nocturnal oximetry parameters.

METHODS

We analyzed oximetry recordings from children with (i) OLD (obliterative bronchiolitis; cystic fibrosis); (ii) snoring and adenotonsillar hypertrophy (SDB); and (iii) no respiratory disorder (controls). The three groups were compared regarding: (i) oxygen desaturation of hemoglobin index (SpO drops ≥3%/h-ODI3) and (ii) basal SpO (average SpO between SpO drops). The associations of oximetry parameters (natural logarithm) with study group were tested using linear regression including age as covariate.

RESULTS

Data of 16 subjects with OLD (median age: 7.3 years; Q25, Q75: 5.4, 12), 22 children with SDB (6.3 years; 4, 9) and 22 controls (6.8 years; 5.6, 10.3) were analyzed. Children with OLD or SDB had significantly lower basal SpO than controls (91.9% [90.8, 93.4] vs 96.3% [96, 97.4] vs 97.6% [97.1, 97.9]; P < 0.01). No subjects in the SDB or control groups had basal SpO < 95%. Children with SDB had significantly higher ODI3 than children with OLD or controls [8.4 episodes/h (6.2, 16.6) vs 4.4 episodes/h (3.6, 6.6) vs 2 episodes/h (1.3, 2.7); P < 0.01]. OLD had the greatest negative effect on basal SpO (R = 0.62; P < 0.001) and SDB the greatest positive effect on ODI3 (R = 0.34; P < 0.001).

CONCLUSION

OLD is associated mostly with reduced basal SpO , whereas SDB is characterized by elevated ODI3.

摘要

目的

尽管阻塞性睡眠呼吸障碍（SDB）儿童夜间血氧饱和度的标准化解读已经取得进展，但其他呼吸系统疾病的血氧饱和度异常仍缺乏相关证据。本研究旨在比较阻塞性肺疾病（OLD）和 SDB 的夜间血氧饱和度参数。

方法

我们分析了（i）OLD（闭塞性细支气管炎；囊性纤维化）、（ii）打鼾和腺样体肥大（SDB）和（iii）无呼吸系统疾病（对照组）儿童的血氧饱和度记录。比较三组间：（i）血红蛋白指数（SpO 下降≥3%/h-ODI3）和（ii）基础 SpO（SpO 下降之间的平均 SpO）的氧减饱和度。使用线性回归（包括年龄作为协变量）测试血氧饱和度参数（自然对数）与研究组的相关性。

结果

共纳入 16 例 OLD 患儿（中位年龄：7.3 岁；Q25、Q75：5.4、12）、22 例 SDB 患儿（6.3 岁；4、9）和 22 例对照组（6.8 岁；5.6、10.3）。与对照组相比，OLD 或 SDB 患儿的基础 SpO 明显较低（91.9%[90.8，93.4] vs 96.3%[96，97.4] vs 97.6%[97.1，97.9]；P<0.01）。SDB 或对照组中无一例患儿的基础 SpO<95%。SDB 患儿的 ODI3 明显高于 OLD 或对照组患儿[8.4 次/h（6.2、16.6）vs 4.4 次/h（3.6、6.6）vs 2 次/h（1.3、2.7）；P<0.01]。OLD 对基础 SpO 的影响最大（R=0.62；P<0.001），SDB 对 ODI3 的影响最大（R=0.34；P<0.001）。