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变应性鼻炎是儿童中-重度阻塞性睡眠呼吸暂停的预测因子。

Allergic rhinitis as a predictor of moderate-to-severe paediatric obstructive sleep apnoea.

机构信息

Department of Otorhinolaryngology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Department of Otorhinolaryngology, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Sleep Breath. 2024 Jun;28(3):1303-1310. doi: 10.1007/s11325-024-03011-6. Epub 2024 Feb 28.

Abstract

PURPOSE

Obstructive sleep apnoea (OSA) is a common sleep-related breathing disorder affecting children. This study aims to characterize factors associated with the development and progression of severe forms of paediatric OSA.

METHODS

This study included children admitted to Children's Hospital of Chongqing Medical University, a tertiary children's hospital in southwest China between January 2020 and December 2020 with a discharge diagnosis of OSA. Each patient underwent polysomnography examination, following assessments of apnoea-hypopnea index (AHI) and lowest oxygen saturation (LSaO) by standardized techniques. Demographic and clinical information was collected from the hospital's electronic medical records. Associations between OSA severity and various factors were first examined in a univariate logistic model, with subsequent multivariate analysis to further identify independent risk factors.

RESULTS

A total of 263 children were identified during the study period. Among patients presenting with OSA, 51.3% had mild and 48.7% had moderate to severe symptoms according to standardized guidelines. The incidence of mild and moderate to severe hypoxemia in our population was 39.2% and 60.8%, respectively. Allergic rhinitis (AR; adjusted odds ratio (aOR) = 1.75, 95% CI 1.03-2.96) and male gender (aOR = 1.77, 95% CI 1.03-3.06) were significantly associated with moderate-to-severe OSA (all P-values < 0.05) after adjustment for covariates. AR was also the only significant predictor of hypoxemia (P < 0.05).

CONCLUSION

Our results suggest that male gender and presence of AR may be associated with an increased likelihood of moderate-to-severe OSA in children. These findings underscore the importance of timely intervention and individualized management for at-risk individuals.

摘要

目的

阻塞性睡眠呼吸暂停(OSA)是一种常见的与睡眠相关的呼吸障碍,影响儿童。本研究旨在描述与儿童重度 OSA 发生和进展相关的因素。

方法

本研究纳入了 2020 年 1 月至 2020 年 12 月期间在重庆医科大学附属儿童医院(中国西南地区的一家三级儿童医院)住院、诊断为 OSA 的患儿。每位患者均接受多导睡眠图检查,并采用标准化技术评估呼吸暂停低通气指数(AHI)和最低血氧饱和度(LSaO)。从医院电子病历中收集人口统计学和临床信息。首先,采用单因素逻辑回归模型检查 OSA 严重程度与各种因素之间的关联,然后进行多因素分析,以进一步确定独立的危险因素。

结果

研究期间共纳入 263 名患儿。根据标准化指南,就诊时 OSA 患儿中,51.3%为轻度,48.7%为中重度。本研究人群中轻度和中重度低氧血症的发生率分别为 39.2%和 60.8%。过敏性鼻炎(AR;调整后的优势比(aOR)=1.75,95%可信区间 1.03-2.96)和男性(aOR=1.77,95%可信区间 1.03-3.06)在调整协变量后,与中重度 OSA 显著相关(均 P 值<0.05)。AR 也是唯一与低氧血症显著相关的预测因子(P<0.05)。

结论

我们的结果表明,男性和 AR 可能与儿童中重度 OSA 的发生几率增加有关。这些发现强调了对高危人群进行及时干预和个体化管理的重要性。

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