OSAS对不同年龄阶段儿童呼吸、睡眠特征和认知能力损害影响比较
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摘要
目的探讨儿童阻塞性睡眠呼吸暂停综合征(OSAS)的睡眠与呼吸特征,分析其对儿童行为认知能力的影响。方法选取2014年1月至2015年1月收治的OSAS患儿70例作为研究对象,将其分成学龄组(39例)与学龄前组(31例),另选取70例体检健康儿童作为对照组。对比分析三组的夜间睡眠、呼吸参数并评价其认知能力。结果OSAS组学龄前期儿童睡眠时间及效率、NREM及REM各期所占比率与对照组相比,均无有显著差异(P>均0.05),但OSAS组学龄前期的唤醒指数及AHI要显著高于对照组(P均<0.05);OSAS组学龄期儿童睡眠Ⅰ、Ⅱ期所占时间较对照组显著延长(P均<0.05),而SWS期所占时间则显著减短(P<0.05),REM所占比率相比则无差异(P>0.05),此外,OSAS组学龄期的唤醒指数及AHI也均要显著高于对照组(P均<0.05)。OSAS组行为能力评分显著高于对照组(P<0.05),认知能力评分与智商评分要显著低于对照组(P均<0.05),且图形化销测试失误分数也要明显高于对照组(P<0.05)。结论学龄前期及学龄期OSAS患儿的睡眠均受到影响,学龄期OSAS患儿睡眠结构改变更为明显,睡眠Ⅰ、Ⅱ期延长、SWS期缩短,睡眠结构明显改变,且睡眠过程中唤醒指数、AHI均增加,患儿的行为认知能力因此而出现一定障碍,及时对患儿进行诊治对其健康成长具有重要意义。
Objective To investigate the Sleep and Respiratory Characteristics and Effect on neurocognitive in childrenwith obstructive sleep apnea syndrome in different age. Methods From January 2014 to January 2015,the 70 cases of children with obstructive sleep apnea syndrome in our hospital were divided into school age group( 39 cases) and preschool group( 31 cases),the other 70 cases of medical healthy children were selected as control group,the three groups of nighttime sleep and respiratory parameters and evaluate its cognitive abilities were analyzed. Results Compared with two groups of preschool children,sleep structureand efficiency,NREM and REM sleep time periods compared proportion,had no significant difference( P > 0. 05),but the arousal index and AHI OSAS group were significantly more than the control group( P < 0. 05); Compared two groups of school- age children sleep structure,sleep OSAS group I,II period of time than control group significantly extended( P < 0. 05),and the SWS periods of time were significantly shorter( P < 0. 05),compared to the proportion of REM,no difference(P > 0. 05),in addition,the arousal index and AHI and OSAS group were significantly more than the control group( P < 0. 05); OSAS group behavior ability score was significantly higher than that of control group( P < 0. 05),the cognitive ability to score and IQ score is significantly lower than that of control group( P < 0. 05),and graphical pin test error scores are obviously higher than that of control group( P < 0. 05). Conclusion Preschool and school- age children with OSAS sleep are affected,school- age children with OSAS sleep structure change is more apparent,protracted sleep I,II,SWS period shorten,sleep structure changes obviously,and wake up index,AHI increase during sleep,the behavior of the children cognitive ability and appear some obstacles,in a timely manner to make a diagnosis and give treatment pre- operation is of great significance for their healthy growth.
Objective To investigate the Sleep and Respiratory Characteristics and Effect on neurocognitive in childrenwith obstructive sleep apnea syndrome in different age. Methods From January 2014 to January 2015,the 70 cases of children with obstructive sleep apnea syndrome in our hospital were divided into school age group( 39 cases) and preschool group( 31 cases),the other 70 cases of medical healthy children were selected as control group,the three groups of nighttime sleep and respiratory parameters and evaluate its cognitive abilities were analyzed. Results Compared with two groups of preschool children,sleep structureand efficiency,NREM and REM sleep time periods compared proportion,had no significant difference( P > 0. 05),but the arousal index and AHI OSAS group were significantly more than the control group( P < 0. 05); Compared two groups of school- age children sleep structure,sleep OSAS group I,II period of time than control group significantly extended( P < 0. 05),and the SWS periods of time were significantly shorter( P < 0. 05),compared to the proportion of REM,no difference(P > 0. 05),in addition,the arousal index and AHI and OSAS group were significantly more than the control group( P < 0. 05); OSAS group behavior ability score was significantly higher than that of control group( P < 0. 05),the cognitive ability to score and IQ score is significantly lower than that of control group( P < 0. 05),and graphical pin test error scores are obviously higher than that of control group( P < 0. 05). Conclusion Preschool and school- age children with OSAS sleep are affected,school- age children with OSAS sleep structure change is more apparent,protracted sleep I,II,SWS period shorten,sleep structure changes obviously,and wake up index,AHI increase during sleep,the behavior of the children cognitive ability and appear some obstacles,in a timely manner to make a diagnosis and give treatment pre- operation is of great significance for their healthy growth.
引文
[1]董亦晗,刘鹏,刘石,等.儿童阻塞性睡眠呼吸暂停低通气综合征患者睡眠呼吸监测分析[J].中国伤残医学,2013,9(5):263-264.
[2]刘大波,钟建文,罗绍鹏,等.小儿阻塞性睡眠呼吸暂停综合征的临床及睡眠呼吸特征[J].中华儿科杂志,2003,41(1):31-34.
[3]戈录芳,康翠清,张秀兰,等.儿童阻塞性睡眠呼吸暂停低通气综合征多导睡眠监测分析[J].临床误诊误治,2012,25(2):86-88.
[4]李明兰,蒋晋安.儿童阻塞性呼吸睡眠暂停低通气综合征的诊治[J].现代医药卫生,2010,26(1):52-54.
[5]庞冲,谷庆隆,吴建新,等.阻塞性睡眠呼吸暂停低通气综合征102例患儿睡眠结构分析[J].中国医药,2012,7(8):944-946.
[6]刘志明,额尔敦高娃,张继华,等.阻塞性睡眠呼吸暂停低通气综合征对儿童智力发育影响的观察[J].河北医药,2012,34(4):513-514.
[7]Hu L,Xu X,Gong Y,et al.Percutaneous Biphasic Electrical Stimulation for Treatment of Obstructive Sleep Apnea Syndrome[J].IEEE Trans Biomed Eng,2008,55(1):181-187.
[8]Algin O,Gokalp G,Ocakoglu G,et al.Neurochemical-structural changes evaluation of brain in patients with obstructive sleep apnea syndrome[J].European Journal of Radiology,2012,81(3):491-495.
[9]Günes S,Polat K,Yosunkaya S.Multi-class f-score feature selection approach to classification of obstructive sleep apnea syndrome[J].Expert Syst.Appl,2010,37(2):998-1004.
[2]刘大波,钟建文,罗绍鹏,等.小儿阻塞性睡眠呼吸暂停综合征的临床及睡眠呼吸特征[J].中华儿科杂志,2003,41(1):31-34.
[3]戈录芳,康翠清,张秀兰,等.儿童阻塞性睡眠呼吸暂停低通气综合征多导睡眠监测分析[J].临床误诊误治,2012,25(2):86-88.
[4]李明兰,蒋晋安.儿童阻塞性呼吸睡眠暂停低通气综合征的诊治[J].现代医药卫生,2010,26(1):52-54.
[5]庞冲,谷庆隆,吴建新,等.阻塞性睡眠呼吸暂停低通气综合征102例患儿睡眠结构分析[J].中国医药,2012,7(8):944-946.
[6]刘志明,额尔敦高娃,张继华,等.阻塞性睡眠呼吸暂停低通气综合征对儿童智力发育影响的观察[J].河北医药,2012,34(4):513-514.
[7]Hu L,Xu X,Gong Y,et al.Percutaneous Biphasic Electrical Stimulation for Treatment of Obstructive Sleep Apnea Syndrome[J].IEEE Trans Biomed Eng,2008,55(1):181-187.
[8]Algin O,Gokalp G,Ocakoglu G,et al.Neurochemical-structural changes evaluation of brain in patients with obstructive sleep apnea syndrome[J].European Journal of Radiology,2012,81(3):491-495.
[9]Günes S,Polat K,Yosunkaya S.Multi-class f-score feature selection approach to classification of obstructive sleep apnea syndrome[J].Expert Syst.Appl,2010,37(2):998-1004.