Children's Hospital Colorado and Division of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
Children's Hospital Colorado, Department of Rehabilitation, University of Colorado School of Medicine, Aurora, CO, USA.
NeuroRehabilitation. 2021;48(4):481-491. doi: 10.3233/NRE-210012.
Patients with cerebral palsy and other static encephalopathies (CP) are known to be at increased risk of sleep-related breathing disorders (SRBD). Few studies have reviewed whether intrathecal baclofen (ITB) can contribute to SRBD.
To assess the prevalence of SRBD in patients with CP receiving ITB by using nocturnal polysomnography (NPSG).
We performed a retrospective chart review of patients receiving ITB who had NPSG at Children's Hospital Colorado (CHCO) and Seattle Children's Hospital (SCH) from 1995 to 2019. The Gross Motor Function Classification System (GMFCS) measured the severity of motor disability. Screening sleep questionnaires collected subjective data and NPSG provided objective data of SRBD.
All patients except one were GMFCS 4 or 5 with median age at ITB pump placement of 9.7 years. The screening questionnaire for SRBD detected one or more nighttime symptoms in > 82% of all patient groups. Pre-ITB criteria for a SRBD was met in 83% of patients at CHCO and 91% at SCH. Post-ITB prevalence remained similarly high.
NPSG identified a high prevalence of SRBD in these cohorts from CHCO and SCH. Our study showed neither improvement nor worsening of SRBD in patients receiving ITB.
已知脑瘫和其他静态脑病（CP）患者存在睡眠相关呼吸障碍（SRBD）的风险增加。很少有研究综述过鞘内巴氯芬（ITB）是否会导致 SRBD。
通过夜间多导睡眠图（NPSG）评估接受 ITB 的 CP 患者中 SRBD 的患病率。
我们对 1995 年至 2019 年期间在科罗拉多儿童医院（CHCO）和西雅图儿童医院（SCH）接受 ITB 治疗且进行了 NPSG 的患者进行了回顾性图表审查。粗大运动功能分类系统（GMFCS）测量运动障碍的严重程度。筛查睡眠问卷收集主观数据，NPSG 提供 SRBD 的客观数据。
除了一名患者外，所有患者的 GMFCS 均为 4 或 5 级，接受 ITB 泵植入的中位年龄为 9.7 岁。所有患者群体中，超过 82%的患者的 SRBD 筛查问卷检测到一个或多个夜间症状。CHCO 中有 83%的患者和 SCH 中有 91%的患者在接受 ITB 前符合 SRBD 标准。接受 ITB 后的患病率仍然很高。
NPSG 在来自 CHCO 和 SCH 的这些队列中确定了 SRBD 的高患病率。我们的研究表明，接受 ITB 的患者的 SRBD 既没有改善也没有恶化。
