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多导睡眠图、睡眠呼吸暂停筛查试验和心肺耦联在小儿阻塞性睡眠呼吸暂停综合征诊断中的比较。

Comparison of polysomnography, sleep apnea screening test and cardiopulmonary coupling in the diagnosis of pediatric obstructive sleep apnea syndrome.

机构信息

Department of Otolaryngology, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Department of Geography, University of British Columbia, Vancouver, Canada.

出版信息

Int J Pediatr Otorhinolaryngol. 2021 Oct;149:110867. doi: 10.1016/j.ijporl.2021.110867. Epub 2021 Aug 5.

Abstract

OBJECTIVE

The study aims to investigate into the correlation between clinical characteristics of pediatric obstructive sleep apnea (OSA) and the results of polysomnography (PSG), sleep apnea screening test (SAST) and cardiopulmonary coupling (CPC) respectively and compare their diagnostic values for pediatric OSA patients.

METHODS

We recruited 239 pediatric OSA patients aged between 2 and 12 from Jan 1, 2017 to Jun 30, 2018. All the patients received PSG, SAST and CPC simultaneously and the results of these three different tests were compared and analyzed together with their clinical features. The relationship between the size of adenoid/tonsil and the severity of OSA was also analyzed.

RESULTS

No statistically significant differences were noted between SAST and PSG in the oxygen desaturation index (ODI) and lowest oxygen saturation (LsO) respectively. No significant statistical difference was noted in the proportion of rapid eye movement sleep between CPC and PSG. The apnea-hypopnea index (AHI) from CPC was significantly lower than that from PSG. In the severe OSA group, no significant statistical difference was noted in AHI between these two tests. However, AHI from CPC was significantly lower than that from PSG in other groups. No statistically significant difference was noted in AHI and ODI among different groups graded by the size of adenoid or tonsil, suggesting that the size of adenoid/tonsil may not be highly related to the severity of OSA.

CONCLUSION

SAST is an acceptable fast screening tool in the assessments of blood oxygen desaturation and further pediatric OSA screening. CPC is capable to screen severe pediatric OSA, but its results should be interpreted with caution for pediatric patients with non-severe OSA. The size of adenoid/tonsil may not be highly related to the severity of OSA.

摘要

目的

研究旨在分别探讨儿科阻塞性睡眠呼吸暂停(OSA)的临床特征与多导睡眠图(PSG)、睡眠呼吸暂停筛查试验(SAST)和心肺耦联(CPC)的相关性,并比较它们对儿科 OSA 患者的诊断价值。

方法

我们招募了 2017 年 1 月 1 日至 2018 年 6 月 30 日期间年龄在 2 至 12 岁的 239 例儿科 OSA 患者。所有患者同时接受 PSG、SAST 和 CPC 检查,并对这三种不同检查的结果进行比较和分析,同时分析腺样体/扁桃体大小与 OSA 严重程度的关系。

结果

SAST 与 PSG 在氧减指数(ODI)和最低血氧饱和度(LsO)方面无统计学差异。CPC 与 PSG 之间快速眼动睡眠比例无显著统计学差异。CPC 的呼吸暂停低通气指数(AHI)明显低于 PSG。在重度 OSA 组中,两种检查的 AHI 无显著统计学差异。但在其他组中,CPC 的 AHI 明显低于 PSG。根据腺样体或扁桃体大小分级的不同组中,AHI 和 ODI 无统计学差异,提示腺样体/扁桃体大小与 OSA 严重程度可能无高度相关性。

结论

SAST 是评估血氧饱和度下降和进一步进行儿科 OSA 筛查的一种可接受的快速筛查工具。CPC 能够筛查严重的儿科 OSA,但对非严重 OSA 的儿科患者,其结果应谨慎解释。腺样体/扁桃体大小与 OSA 严重程度可能无高度相关性。

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