儿童严重哮喘患者睡眠呼吸障碍与哮喘控制的性别差异。
Sex differences in the relationship of sleep-disordered breathing and asthma control among children with severe asthma.
机构信息
Division of Pulmonary Medicine, Boston Children's Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
出版信息
J Asthma. 2022 Jun;59(6):1148-1156. doi: 10.1080/02770903.2021.1897838. Epub 2021 Mar 23.
OBJECTIVE
Children with severe asthma are underrepresented in studies of the relationship of sleep-disordered breathing (SDB) and asthma and little is known about sex differences of these relationships. We sought to determine the relationship of SDB with asthma control and lung function among boys and girls within a pediatric severe asthma cohort.
METHODS
Patients attending clinic visits at the Boston Children's Hospital Pediatric Severe Asthma Program completed the Pediatric Sleep Questionnaire (PSQ), Asthma Control Test (ACT) and Spirometry. The prevalence of SDB was defined as a PSQ score >0.33. We analyzed the association between PSQ score and both ACT score and spirometry values in mixed effect models, testing interactions for age and sex.
RESULTS
Among 37 subjects, mean age was 11.8 years (4.4) and 23 (62.2%) were male, the prevalence of SDB was 43.2% (16/37). Including all 80 observations, there was a moderate negative correlation between PSQ and ACT scores (r=-0.46, < 0.001). Multivariable linear regression models revealed a significant sex interaction with PSQ on asthma control ( = 0.003), such that for each 0.10 point increase in PSQ there was a 1.88 point decrease in ACT score for females but only 0.21 point decrease in ACT score for males. A positive PSQ screen was associated with a 9.44 point (CI 5.54, 13.34, < 0.001) lower ACT score for females and a 3.22 point (CI 0.56, 5.88, = 0.02) lower score for males.
CONCLUSIONS
SDB is common among children with severe asthma. Among children with severe asthma, SDB in girls portends to significantly worse asthma control than boys.
UNLABELLED
Supplemental data for this article is available online at https://doi.org/10.1080/02770903.2021.1897838.
目的
患有严重哮喘的儿童在睡眠呼吸障碍（SDB）与哮喘关系的研究中代表性不足，对于这些关系的性别差异知之甚少。我们旨在确定在儿科严重哮喘队列中，SDB 与男孩和女孩哮喘控制和肺功能之间的关系。
方法
在波士顿儿童医院儿科严重哮喘项目就诊的患者完成了儿科睡眠问卷（PSQ）、哮喘控制测试（ACT）和肺量计检查。SDB 的患病率定义为 PSQ 评分>0.33。我们在混合效应模型中分析了 PSQ 评分与 ACT 评分和肺功能值之间的关联，检验了年龄和性别之间的交互作用。
结果
在 37 名受试者中，平均年龄为 11.8 岁（4.4），23 名（62.2%）为男性，SDB 的患病率为 43.2%（16/37）。包括 80 个观察值，PSQ 与 ACT 评分呈中度负相关（r=-0.46， < 0.001）。多变量线性回归模型显示 PSQ 对哮喘控制的性别交互作用显著（ = 0.003），即 PSQ 每增加 0.10，女性的 ACT 评分就会降低 1.88 分，而男性的 ACT 评分仅降低 0.21 分。PSQ 阳性与女性 ACT 评分降低 9.44 分（CI 5.54, 13.34， < 0.001）和男性 ACT 评分降低 3.22 分（CI 0.56, 5.88， = 0.02）显著相关。
结论
SDB 在患有严重哮喘的儿童中很常见。在患有严重哮喘的儿童中，SDB 在女孩中预示着哮喘控制明显比男孩差。
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