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Prader-Willi 综合征患儿睡眠保存对呼吸紊乱程度相同。

Preserved Sleep for the Same Level of Respiratory Disturbance in Children with Prader-Willi Syndrome.

机构信息

Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada.

Women & Children's Health Research Institute, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada.

出版信息

Int J Mol Sci. 2022 Sep 13;23(18):10580. doi: 10.3390/ijms231810580.

Abstract

Debate remains as to how to balance the use of recombinant human growth hormone (rhGH) as an important treatment in Prader-Willi syndrome (PWS) with its potential role in obstructive sleep apnea. This single-center, retrospective study assessed differences in overnight polysomnography results between children with and without PWS and changes in respiratory parameters before and after the initiation of rhGH treatment in those with PWS. Compared with age-, sex-, and body-mass-index-matched controls (n = 87), children with PWS (n = 29) had longer total sleep time (434 ± 72 vs. 365 ± 116 min; p < 0.01), higher sleep efficiency (86 ± 7 vs. 78 ± 15%; p < 0.05), and lower arousal events (8.1 ± 4.5 vs. 13.0 ± 8.9 events/h; p < 0.05). Mean oxygen saturation was lower in PWS children (94.3 ± 6.0 vs. 96.0 ± 2.0%; p < 0.05), with no other differences in respiratory parameters between groups. Eleven children with PWS (38%) met the criteria for further analyses of the impact of rhGH; polysomnography parameters did not change with treatment. Compared with other children undergoing polysomnography, children with PWS had more favorable markers of sleep continuity and lower oxygen saturation for the same level of respiratory disturbance. rhGH administration was not associated with changes in respiratory parameters in PWS.

摘要

关于如何平衡使用重组人生长激素(rhGH)作为 Prader-Willi 综合征(PWS)的重要治疗方法,及其在阻塞性睡眠呼吸暂停中的潜在作用,仍存在争议。本单中心回顾性研究评估了有无 PWS 的儿童之间整夜多导睡眠图结果的差异,以及在开始 rhGH 治疗前后 PWS 患者呼吸参数的变化。与年龄、性别和体重指数匹配的对照组(n = 87)相比,PWS 患儿(n = 29)的总睡眠时间更长(434 ± 72 比 365 ± 116 min;p < 0.01),睡眠效率更高(86 ± 7 比 78 ± 15%;p < 0.05),觉醒事件更少(8.1 ± 4.5 比 13.0 ± 8.9 次/小时;p < 0.05)。PWS 患儿的平均氧饱和度较低(94.3 ± 6.0 比 96.0 ± 2.0%;p < 0.05),但两组间呼吸参数无其他差异。11 名 PWS 患儿(38%)符合进一步分析 rhGH 影响的标准;多导睡眠图参数未随治疗而变化。与其他接受多导睡眠图检查的儿童相比,患有 PWS 的儿童的睡眠连续性指标更为有利,而呼吸障碍程度相同的情况下,氧饱和度较低。rhGH 给药与 PWS 患者的呼吸参数变化无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ce4/9501212/89abac6dcdcb/ijms-23-10580-g001.jpg

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