CAJ | 학술논문

目的探讨睡眠呼吸障碍( sleep-disordered breathing,SDB)患儿睡眠质量评估中能较好反映不同病情患儿睡眠片段化程度的参数.方法 2009年10月至2011年8月收治的4～8岁符合阻塞性睡眠呼吸暂停低通气综合征(OSAHS)诊断[阻塞性呼吸暂停指数(OAI) ＞1次/h或呼吸暂停低通气指数(AHI) ＞5次/h,最低血氧饱和度(LSaO2)＜ 0.92]45例患儿为OSAHS组,AHI≥1次/h且≤5次/h及OAI≤1次/h的54例患儿为SDB组,18例无SDB症状的声带小结患儿(AHI＜1次/h,LSaO2≥O.92)作为对照组.比较3组之间呼吸相关性脑电醒觉反应指数(respiratory arousal index,RAI)、自发性脑电醒觉反应指数(spontaneous arousal index,SAI)及总的脑电醒觉反应指数(total arousal index,ARtotI)及睡眠压力分数(sleep pressure score,SPS)的差异,分析这些参数与AHI的相关性.14例有手术前后多道睡眠图(PSG)监测资料的OSAHS患儿进行手术前后的参数对比.结果 SDB组、OSAHS组及对照组之间SPS、RAI、SAI及ARtotI参数比较,除SDB组和OSAHS组的SAI及ARtotI、OSAHS组和对照组的ARtotI的差异无统计学意义外(P值均＞0.017),其余两两比较的差异均有统计学意义(P值均＜0.017).SPS、RAI与AHI呈正相关(相关系数r分别为0.751和0.829,P值均为0.000).14例OSAHS患儿手术前后SPS及RAI的下降差异有统计学意义(Z值分别为-3.045和-2.982,P值分别为0.002和0.003).SDB组、OSAHS组及对照组之间睡眠结构的差异无统计学意义.结论 SPS及RAI作为脑电醒觉方面的指标,能较好地反映睡眠片段化随病情变化的程度.
목적 탐토수면호흡장애( sleep-disordered breathing,SDB)환인수면질량평고중능교호반영불동병정환인수면편단화정도적삼수.방법 2009년10월지2011년8월수치적4～8세부합조새성수면호흡잠정저통기종합정(OSAHS)진단[조새성호흡잠정지수(OAI) ＞1차/h혹호흡잠정저통기지수(AHI) ＞5차/h,최저혈양포화도(LSaO2)＜ 0.92]45례환인위OSAHS조,AHI≥1차/h차≤5차/h급OAI≤1차/h적54례환인위SDB조,18례무SDB증상적성대소결환인(AHI＜1차/h,LSaO2≥O.92)작위대조조.비교3조지간호흡상관성뇌전성각반응지수(respiratory arousal index,RAI)、자발성뇌전성각반응지수(spontaneous arousal index,SAI)급총적뇌전성각반응지수(total arousal index,ARtotI)급수면압력분수(sleep pressure score,SPS)적차이,분석저사삼수여AHI적상관성.14례유수술전후다도수면도(PSG)감측자료적OSAHS환인진행수술전후적삼수대비.결과 SDB조、OSAHS조급대조조지간SPS、RAI、SAI급ARtotI삼수비교,제SDB조화OSAHS조적SAI급ARtotI、OSAHS조화대조조적ARtotI적차이무통계학의의외(P치균＞0.017),기여량량비교적차이균유통계학의의(P치균＜0.017).SPS、RAI여AHI정정상관(상관계수r분별위0.751화0.829,P치균위0.000).14례OSAHS환인수술전후SPS급RAI적하강차이유통계학의의(Z치분별위-3.045화-2.982,P치분별위0.002화0.003).SDB조、OSAHS조급대조조지간수면결구적차이무통계학의의.결론 SPS급RAI작위뇌전성각방면적지표,능교호지반영수면편단화수병정변화적정도.
Objective To explore which index is more suitable to show the degree of sleep fragment in children with sleep-disordered breathing (SDB).Methods Between October 2009 and August 2011,Forty-five children (4 - 8 years ) who were diagnosed as obstructive sleep apnea hypopnea syndrome (OSAHS) were enrolled in OSAHS group [obstructive apnea index (OAI) ＞ 1 times/h or apnea hypopnea index (AHI) ＞5 times/h,lowest oxygen saturation (LSaO2) ＜0.92＝ and 54 children were enrolled in SDB group( 1 ≤AHI≤5 times/h and OAI ≤ 1 times/h),18 children with chorditis nodulosa made up control group ( AHI ＜ 1 times/h and LSaO2 ≥ 0.92,without SDB-related history＝.The difference of respiratory arousal index (RAI),spontaneous arousal index (SAI),total arousal index (ARtotI) and sleep pressure score (SPS) were compared among three groups.The correlation between RAI,SAI,ARtotI,SPS and AHI were also analyzed.Furthermore,RAI,SAI,ARtotI and SPS were compared before and after operation in 14 OSAHS children with detailed pre- and after polysomnography data.Results The difference of SAI and ARtotI between SDB group and OSAHS group and ARtotI between OSAHS group and control group were not significant (P ＞ 0.017),except this,the difference of other index between any two groups or SAI and ARtotI between otherwise two groups were significant (P ＜0.017＝.RAI and SPS was correlated with AHI (coefficient correlation:0.751,0.829,P was 0.000). RAI and SPS decreased after operation and the difference was significant ( Z were - 3.045 and - 2.982,P were 0.002 and 0.003 ). The difference of sleep structure was not significant.Conclusions RAI and SPS were more suitable to show the degree of sleep fragment than other arousal index.