Engelberts A C
Department of Pediatrics, Stichting Deventer Ziekenhuizen, Netherlands.
Int J Pediatr Otorhinolaryngol. 1995 Jun;32 Suppl:S59-62. doi: 10.1016/0165-5876(94)01143-l.
In sudden infant death syndrome (SIDS) apnea is the terminal event; whether or not an obstructive apnea is the primary event is unknown. Collapse of the pliable pharyngeal airway during life would not be detected after death and is therefore hard to prove. The distinctive distribution of petechiae at necropsy can be explained by negative intrathoracic pressure before death suggesting upper airway obstruction. Obstructive sleep apneas have been documented in subsequent SIDS victims: however, polysomnography is not predictive for individual infants. It is unknown how many ALTE (apparent life threatening event) infants would have died of SIDS without intervention. About 4-10% of these events are caused by upper airway obstruction. There have been well documented cases of ALTE infants who in time developed the symptoms of obstructive sleep apnea syndrome (OSAS). Obstructive apnea certainly causes some cases of ALTE; whether it also causes a subgroup of SIDS is unknown.
在婴儿猝死综合征（SIDS）中，呼吸暂停是终末事件；阻塞性呼吸暂停是否为首要事件尚不清楚。生前柔软的咽部气道塌陷在死后无法检测到，因此很难证实。尸检时瘀点的独特分布可以用死亡前的胸内负压来解释，提示上呼吸道阻塞。在随后的SIDS受害者中已记录到阻塞性睡眠呼吸暂停；然而，多导睡眠图对个体婴儿并无预测作用。不知道有多少“看上去有生命危险事件”（ALTE）婴儿如果不进行干预会死于SIDS。这些事件中约4-10%是由上呼吸道阻塞引起的。有充分记录的ALTE婴儿病例，这些婴儿后来出现了阻塞性睡眠呼吸暂停综合征（OSAS）的症状。阻塞性呼吸暂停肯定导致了一些ALTE病例；它是否也导致了SIDS的一个亚组尚不清楚。
