Duenas-Meza Elida, Escamilla-Gil María Isabel, Bazurto-Zapata María Angelica, Caparo Elizabeth, Suarez Cuartas Miguel, Rincón Martínez Laura, Pernett Buenaver Lizbeth, Rojas Ortega Ariana, Torres Jorge, Restrepo-Gualteros Sonia, Parra Buitrago Andrea, Gonzalez-Garcia Mauricio
Fundación Neumológica Colombiana, Sleep center, Bogotá, Colombia.
Universidad de La Sabana, Chia, Colombia.
Sleep. 2022 Jan 11;45(1). doi: 10.1093/sleep/zsab208.
The aim of this study was to determine the impact of apneas on oxygen saturation and the presence of intermittent hypoxia, during sleep of preterm infants (PTIs) born at high altitudes and compare with full-term infants (FTIs) at the same altitude.
PTIs and FTIs from 3 to 18 months were included. They were divided into three age groups: 3-4 months (Group 1); 6-7 months (Group 2), and 10-18 months (Group 3). Polysomnography parameters and oxygenation indices were evaluated. Intermittent hypoxia was defined as brief, repetitive cycles of decreased oxygen saturation. Kruskal-Wallis test for multiple comparisons, t-test or Mann-Whitney U-test were used.
127 PTI and 175 FTI were included. Total apnea-hypopnea index (AHI) was higher in PTI that FTI in all age groups (Group 1: 33.5/h vs. 12.8/h, p = 0.042; Group 2: 27.0/h vs. 7.4/h, p < 0.001; and Group 3: 11.6/h vs. 3.1/h, p < 0.001). In Group 3, central-AHI (8.0/h vs. 2.3/h, p < 0.001) and obstructive-AHI (1.8/h vs. 0.6/h, p < 0.008) were higher in PTI than FTI. T90 (7.0% vs. 0.5, p < 0.001), oxygen desaturation index (39.8/h vs. 11.3, p < 0.001) were higher in PTI than FTI, nadir SpO2 (70.0% vs. 80.0, p<0.001) was lower in PTI.
At high altitude, compared to FTI, PTI have a higher rate of respiratory events, greater desaturation, and a delayed resolution of these conditions, suggesting the persistence of intermittent hypoxia during the first 18 months of life. This indicates the need for follow-up of these infants for timely diagnosis and treatment of respiratory disturbances during sleep.
本研究旨在确定高海拔地区出生的早产儿（PTIs）睡眠期间呼吸暂停对血氧饱和度和间歇性缺氧的影响，并与同一海拔地区的足月儿（FTIs）进行比较。
纳入3至18个月的PTIs和FTIs。他们被分为三个年龄组：3 - 4个月（第1组）；6 - 7个月（第2组），以及10 - 18个月（第3组）。评估多导睡眠图参数和氧合指数。间歇性缺氧被定义为血氧饱和度短暂、重复下降的周期。使用Kruskal-Wallis检验进行多重比较，t检验或Mann-Whitney U检验。
纳入127例PTIs和175例FTIs。在所有年龄组中，PTIs的总呼吸暂停低通气指数（AHI）均高于FTIs（第1组：33.5次/小时 vs. 12.8次/小时，p = 0.042；第2组：27.0次/小时 vs. 7.4次/小时，p < 0.001；第3组：11.6次/小时 vs. 3.1次/小时，p < 0.001）。在第3组中，PTIs的中枢性AHI（8.0次/小时 vs. 2.3次/小时，p < 0.001）和阻塞性AHI（1.8次/小时 vs. 0.6次/小时，p < 0.008）高于FTIs。PTIs的T90（7.0% vs. 0.5，p < 0.001）、氧饱和度下降指数（39.8次/小时 vs. 11.3，p < 0.001）高于FTIs，最低血氧饱和度（SpO2）（70.0% vs. 80.0，p < 0.001）低于FTIs。
在高海拔地区，与FTIs相比，PTIs的呼吸事件发生率更高，血氧饱和度下降更严重，且这些情况的缓解延迟，表明在生命的前18个月期间间歇性缺氧持续存在。这表明需要对这些婴儿进行随访，以便及时诊断和治疗睡眠期间的呼吸障碍。
