Department of Pediatric Pulmonology and Cardiology, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
Division of Public Health, School of Medicine, Pontificia Universidad Católica de Chile.
J Asthma. 2020 Jun;57(6):584-592. doi: 10.1080/02770903.2019.1599385. Epub 2019 Apr 5.
: Sleep-disordered breathing (SDB) is highly prevalent in school children with poorly-controlled asthma. However, this association has not been assessed in preschoolers with recurrent wheeze, nor in those at risk for asthma. We hypothesized that preschoolers with asthma risk (positive asthma predictive index [API]) have a higher prevalence of SDB and higher inflammatory biomarkers (blood-hsCRP and urinary-LTE4) levels than those with negative API.: Children 2 to 5 years of age with recurrent wheezing were classified as positive or negative API. SDB was determined by the pediatric sleep questionnaire (PSQ) and its subscale (PSQSub6). Demographic characteristics, spirometry, blood hsCRP and urinary LTE4 were assessed.: We enrolled 101 preschoolers: 70 completed all measurements, 55.4% were males, mean age 4.07 ± 0.87 years, 45% overweight or obese, 70% had positive API, 87.5% had rhinitis. The prevalence of SDB measured by PSQ was 40.8% and by PSQSub6 was 29.6%. However, the proportion of SDB was similar between positive and negative API groups. The hsCRP (mean ± SD) was higher in the positive than in negative API (3.58 ± 0.58 and 1.32 ± 0.36 mg/L, = 0.69, respectively); moreover, no differences in urinary LTE4 were found between groups. No correlation of PSQ (+) or PSQSub6 (+) with hsCRP and uLTE4 was found. However, preschoolers with positive API had significantly more post-bronchodilator percentage change in FEF25-75 than negative API (24.14 ± 28.1 vs. 4.13 ± 21.8, respectively, = 0.01).: In preschoolers with recurrent wheezing, we should be investigating for the coexistence of SDB, using early screening methods for detecting those conditions.
睡眠呼吸障碍（SDB）在哮喘控制不佳的学龄儿童中非常普遍。然而，这种关联尚未在有反复喘息的学龄前儿童或有哮喘风险的儿童中进行评估。我们假设哮喘风险较高的学龄前儿童（阳性哮喘预测指数 [API]）的 SDB 患病率更高，且炎症生物标志物（血液 hsCRP 和尿 LTE4）水平更高，而非 API 阴性的儿童。
研究对象为 2 至 5 岁反复喘息的儿童，将其分为阳性或阴性 API。通过儿科睡眠问卷（PSQ）及其子量表（PSQSub6）来确定 SDB。评估了人口统计学特征、肺功能、血液 hsCRP 和尿 LTE4。
我们共纳入了 101 名学龄前儿童：其中 70 名完成了所有测量，男童占 55.4%，平均年龄为 4.07±0.87 岁，45%超重或肥胖，70%API 阳性，87.5%患有鼻炎。PSQ 测量的 SDB 患病率为 40.8%，PSQSub6 为 29.6%。然而，API 阳性和阴性组的 SDB 比例相似。hsCRP（均值±标准差）在 API 阳性组中高于阴性组（分别为 3.58±0.58 和 1.32±0.36mg/L， = 0.69）；此外，两组之间的尿 LTE4 无差异。PSQ（+）或 PSQSub6（+）与 hsCRP 和 uLTE4 之间均无相关性。然而，API 阳性的学龄前儿童支气管扩张剂后 FEF25-75 百分比变化明显高于 API 阴性者（分别为 24.14±28.1 和 4.13±21.8， = 0.01）。
在有反复喘息的学龄前儿童中，我们应该使用早期筛查方法来调查 SDB 的共存情况，以便发现这些情况。
