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[神经肌肉疾病患儿睡眠呼吸障碍的临床特征]

[Clinical features of sleep-disordered breathing in children with neuromuscular disease].

作者信息

Yang Qin, Bao Yan-Min, Lu Xin-Guo, Yun Guo-Jun, Liu Ai-Liang, Zheng Yue-Jie, Wen Fei-Qiu

机构信息

Department of Respiratory Medicine, Shenzhen Children's Hospital, Shenzhen, Guangdong 518026, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2021 Feb;23(2):158-163. doi: 10.7499/j.issn.1008-8830.2011030.

Abstract

OBJECTIVE

To study the clinical features of sleep-disordered breathing (SDB) in children with neuromuscular disease (NMD).

METHODS

A retrospective analysis was performed on the medical data of 18 children who were diagnosed with NMD and underwent polysomnography (PSG) (NMD group). Eleven children without NMD who had abnormal sleeping habit and normal sleep structure on PSG were enrolled as the control group. The two groups were compared in terms of the daily and nocturnal symptoms of SDB, incidence rate of obstructive sleep apnea (OSA), pulmonary function, end-tidal partial pressure of carbon dioxide (PetCO), features of sleep structure, and sleep respiratory events.

RESULTS

In the NMD group, 16 children (89%) had related daily and nocturnal symptoms of SDB, and the youngest age was 1 year at the onset of such symptoms. Compared with the control group, the NMD group had significant reductions in total sleep time and sleep efficiency ( < 0.05), a significant reduction in the proportion of rapid eye movement (REM) sleep ( < 0.05), significant increases in obstructive apnea and hypopnea events ( < 0.05) and oxygen reduction events during REM sleep ( < 0.05), and a significant reduction in blood oxygen saturation during REM sleep ( < 0.05). In the NMD group, 17 children (94%) were diagnosed with OSA, and all children had normal lung function and PetCO.

CONCLUSIONS

There is a high proportion of children with SDB among the children with NMD, and SDB can be observed in the early stage of NMD, which results in the damage of sleep structure and the reduction in sleep efficiency. Respiratory events are mainly obstructive events, and oxygen reduction events are mainly observed during REM sleep.

摘要

目的

研究神经肌肉疾病(NMD)患儿睡眠呼吸障碍(SDB)的临床特征。

方法

对18例诊断为NMD并接受多导睡眠图(PSG)检查的患儿的医学资料进行回顾性分析(NMD组)。选取11例无NMD但睡眠习惯异常且PSG睡眠结构正常的患儿作为对照组。比较两组SDB的日间和夜间症状、阻塞性睡眠呼吸暂停(OSA)发生率、肺功能、呼气末二氧化碳分压(PetCO)、睡眠结构特征及睡眠呼吸事件。

结果

NMD组中,16例患儿(89%)有SDB相关的日间和夜间症状,此类症状最早发病年龄为1岁。与对照组相比,NMD组总睡眠时间和睡眠效率显著降低(P<0.05),快速眼动(REM)睡眠比例显著降低(P<0.05),阻塞性呼吸暂停和低通气事件显著增加(P<0.05),REM睡眠期氧减事件显著增加(P<0.05),REM睡眠期血氧饱和度显著降低(P<0.05)。NMD组中,17例患儿(94%)被诊断为OSA,所有患儿肺功能和PetCO均正常。

结论

NMD患儿中SDB的比例较高,且在NMD早期即可出现SDB,导致睡眠结构受损和睡眠效率降低。呼吸事件主要为阻塞性事件,氧减事件主要出现在REM睡眠期。

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