CAJ | 학술논문

目的研究睡眠呼吸障碍(sleep-disordered breathing,SDB)儿童周期性肢体运动指数(periodic limb movement index,PLMI)与最低血氧饱和度(lowest arterial oxygen saturation,LsaO_2)、呼吸暂停低通气指数(AHI)等的关系.方法 2008年3月至2009年5月因疑似OSAHS而进行多道睡眠监测(PSG)的64例儿童作为研究对象,诊断为OSAHS的患儿30例(OSAHS组).另外34例患儿(其他SDB组)有32例单纯鼾症及2例上气道阻力综合征,两组之间进行PLMI及睡眠期伴有脑电醒觉反应的周期性肢体运动事件指数(periodic limb movement index associated with arousals,PLMI-arousal)的比较.64例患儿再以PLMI 5次/h为界分成两组,比较两组之间的睡眠结构和睡眠效果.不同的分组方法所分成的两组之间年龄、性别及体质量指数均衡性检验差异无统计学意义.结果 OSAHS组与其他SDB组的PLMI及PLMI-arousal的差异无统计学意义(z值分别为-1.279、-1.490,P值均>0.05).PLMI≥5次/h组和PLMI<5次/h组比较,PLMI≥5次/h组的睡眠Ⅰ期增多,差异有统计学意义(t=-2.16,P<0.05);其他睡眠期及睡眠效率的差异无统计学意义(P值均>0.05).PLMI≥5次/h组和PLMI<5次/h组的AHI、呼吸暂停指数、低通气指数、LSaO_2及腩电醒觉反应指数比较,差异均无统计学意义(P值均>0.05).64例患儿PLMI及PLMI-arousal与睡眠呼吸障碍的指标无明显相关性(P值均>0.05).结论 PLMS与目前反映SDB病情程度的一些参数之间无相关性,PLMS可能对SDB患儿的睡眠结构影响不大.
목적 연구수면호흡장애(sleep-disordered breathing,SDB)인동주기성지체운동지수(periodic limb movement index,PLMI)여최저혈양포화도(lowest arterial oxygen saturation,LsaO_2)、호흡잠정저통기지수(AHI)등적관계.방법 2008년3월지2009년5월인의사OSAHS이진행다도수면감측(PSG)적64례인동작위연구대상,진단위OSAHS적환인30례(OSAHS조).령외34례환인(기타SDB조)유32례단순한증급2례상기도조력종합정,량조지간진행PLMI급수면기반유뇌전성각반응적주기성지체운동사건지수(periodic limb movement index associated with arousals,PLMI-arousal)적비교.64례환인재이PLMI 5차/h위계분성량조,비교량조지간적수면결구화수면효과.불동적분조방법소분성적량조지간년령、성별급체질량지수균형성검험차이무통계학의의.결과 OSAHS조여기타SDB조적PLMI급PLMI-arousal적차이무통계학의의(z치분별위-1.279、-1.490,P치균>0.05).PLMI≥5차/h조화PLMI<5차/h조비교,PLMI≥5차/h조적수면Ⅰ기증다,차이유통계학의의(t=-2.16,P<0.05);기타수면기급수면효솔적차이무통계학의의(P치균>0.05).PLMI≥5차/h조화PLMI<5차/h조적AHI、호흡잠정지수、저통기지수、LSaO_2급남전성각반응지수비교,차이균무통계학의의(P치균>0.05).64례환인PLMI급PLMI-arousal여수면호흡장애적지표무명현상관성(P치균>0.05).결론 PLMS여목전반영SDB병정정도적일사삼수지간무상관성,PLMS가능대SDB환인적수면결구영향불대.
Objective To explore the correlation between periodic limb movement index (PLMI) and the apnea-hypopnea index (AHI), apnea index (AI), hypopnea index (HI) and lowest oxygen saturation (LSaO_2) in sixty-four children with sleep-disordered breathing(SDB).Methods Between March 2008 and May 2009, sixty-four children suspected of OSAHS underwent overnight polysomnogram monitoring in our medicine sleep center.OSAHS was diagnosed according to the general criterion.Sixty-four children were divided into two groups.Thirty children were diagnosed as OSAHS and 34 children were diagnosed as primary snoring (PS, 32 children) or upper airway resistance syndrome (UARS, 2 children).The difference of PLMI and periodic limb movement index during sleep associated with arousals (PLMl-arousal) were compared between the two groups.Besides this, the correlation between PLMI, periodic limb movement index during sleep associated with arousals and AHI, AI, HI and LSaO_2 were also analyzed in all SDB children.Furthermore, all SDB children were divided into two groups according to PLMI (< 5 events/h vs ≥5 events/h).AHI, AI, HI, LSaO_2 and sleep structure were compared between the two groups.Results ①The difference of PLMI and PLMI-arousal between the children with OSAHS and children with other SDB types(PS and UARS) were not significant (z value, - 1.279, - 1.490; P value, 0.201,0.136, respectively).② The increased sleep stage I was significant as being compared between the two groups (<5 events/h vs ≥5 events/h, t = -2.16, P <0.05).However, other sleep stages and sleep efficiency were not significantly different (P value, all > 0.05).③ The difference of HI, AI, AHI, arousals index (ArI) and LSaO_2 were not significant between the two groups(<5 events/h vs ≥5 events/h, P value, all > 0.05).④ PLMI and PLMI-arousal were not correlated with AHI, HI, AI, AHI and LSaO_2 (Spearman rank correlation analysis).Conclusions PLMS may be independent of SDB and PLMS had a little influce on sleep structure.