中国眼耳鼻喉科杂志
中國眼耳鼻喉科雜誌
중국안이비후과잡지
CHINESE JOURNAL OF OPHTHALMOLOGY AND OTOLARYNGOLOGY
2014年
5期
316-319
,共4页
胡庆磊%杨扬%周焕%白素娟
鬍慶磊%楊颺%週煥%白素娟
호경뢰%양양%주환%백소연
睡眠呼吸暂停低通气,阻塞性%流行病学%儿童
睡眠呼吸暫停低通氣,阻塞性%流行病學%兒童
수면호흡잠정저통기,조새성%류행병학%인동
Sleep apnea-hypopnea,obstructive%Epidemiology%Children
目的：了解上海市普陀区4～7岁儿童阻塞性睡眠呼吸暂停低通气综合征（ OSAHS ）的患病率及相关危险因素，探讨问卷调查在筛选疑似病例中的价值。方法以班级为单位采取整群抽样的方法从上海市普陀区幼儿园及小学一年级中抽取4～7岁学生6000例，由学生家长填写问卷，再从中随机抽取无打鼾或轻微打鼾者10例，有频繁打鼾症状的儿童42例，行多导睡眠监测。结果实际调查人数5040（应答率为84．0％），有效问卷4045份（有效率为80．23％），按睡眠呼吸暂停低通气指数（AHI）≥5次/h、最低血氧饱和度（LSaO2）≤0．94为标准，根据多导睡眠监测结果，估算上海市4～7岁儿童OSAHS的患病率为3．91％。 AHI与腺样体肥大相关性较强（偏相关系数为0．373）；将问卷中打鼾、憋气、反复翻身、夜尿发生率等选项分配一个0～4分的数值，调查问卷得分与AHI呈正相关（r＝0．518）。问卷中打鼾、张口呼吸选项的敏感度较高（95％、87％），特异性一般（67％、79％）；憋气、憋醒选项敏感度一般（66％、29％），特异度较高（93％、100％）；夜尿及反复翻身选项无统计学意义（P＞0．05）。结论上海市普陀区4～7岁儿童OSAHS的患病率估计为3．91％，腺样体肥大为患病主要原因；设计合理的调查问卷可用于初步筛选儿童OSAHS疑似病例，对早期诊断和治疗具有重要参考价值。（中国眼耳鼻喉科杂志，2014，14：316-319）
目的：瞭解上海市普陀區4～7歲兒童阻塞性睡眠呼吸暫停低通氣綜閤徵（ OSAHS ）的患病率及相關危險因素，探討問捲調查在篩選疑似病例中的價值。方法以班級為單位採取整群抽樣的方法從上海市普陀區幼兒園及小學一年級中抽取4～7歲學生6000例，由學生傢長填寫問捲，再從中隨機抽取無打鼾或輕微打鼾者10例，有頻繁打鼾癥狀的兒童42例，行多導睡眠鑑測。結果實際調查人數5040（應答率為84．0％），有效問捲4045份（有效率為80．23％），按睡眠呼吸暫停低通氣指數（AHI）≥5次/h、最低血氧飽和度（LSaO2）≤0．94為標準，根據多導睡眠鑑測結果，估算上海市4～7歲兒童OSAHS的患病率為3．91％。 AHI與腺樣體肥大相關性較彊（偏相關繫數為0．373）；將問捲中打鼾、憋氣、反複翻身、夜尿髮生率等選項分配一箇0～4分的數值，調查問捲得分與AHI呈正相關（r＝0．518）。問捲中打鼾、張口呼吸選項的敏感度較高（95％、87％），特異性一般（67％、79％）；憋氣、憋醒選項敏感度一般（66％、29％），特異度較高（93％、100％）；夜尿及反複翻身選項無統計學意義（P＞0．05）。結論上海市普陀區4～7歲兒童OSAHS的患病率估計為3．91％，腺樣體肥大為患病主要原因；設計閤理的調查問捲可用于初步篩選兒童OSAHS疑似病例，對早期診斷和治療具有重要參攷價值。（中國眼耳鼻喉科雜誌，2014，14：316-319）
목적：료해상해시보타구4～7세인동조새성수면호흡잠정저통기종합정（ OSAHS ）적환병솔급상관위험인소，탐토문권조사재사선의사병례중적개치。방법이반급위단위채취정군추양적방법종상해시보타구유인완급소학일년급중추취4～7세학생6000례，유학생가장전사문권，재종중수궤추취무타한혹경미타한자10례，유빈번타한증상적인동42례，행다도수면감측。결과실제조사인수5040（응답솔위84．0％），유효문권4045빈（유효솔위80．23％），안수면호흡잠정저통기지수（AHI）≥5차/h、최저혈양포화도（LSaO2）≤0．94위표준，근거다도수면감측결과，고산상해시4～7세인동OSAHS적환병솔위3．91％。 AHI여선양체비대상관성교강（편상관계수위0．373）；장문권중타한、별기、반복번신、야뇨발생솔등선항분배일개0～4분적수치，조사문권득분여AHI정정상관（r＝0．518）。문권중타한、장구호흡선항적민감도교고（95％、87％），특이성일반（67％、79％）；별기、별성선항민감도일반（66％、29％），특이도교고（93％、100％）；야뇨급반복번신선항무통계학의의（P＞0．05）。결론상해시보타구4～7세인동OSAHS적환병솔고계위3．91％，선양체비대위환병주요원인；설계합리적조사문권가용우초보사선인동OSAHS의사병례，대조기진단화치료구유중요삼고개치。（중국안이비후과잡지，2014，14：316-319）
Objective To study the prevalence and the highly related factors of obstructive sleep apnea hypopnea syndrome ( OSAHS) in children aged from 4 to 7 years in Putuo District of Shanghai and to explore the value of questionnaire in screening the suspected cases .Methods Using the class as a unit cluster sampled from kindergarten and the first grade of primary school in Shanghai , Putuo District,6 000 students aged form 4 to 7 years were extracted . The questionnaire was filled out by their parents .Fifty-two children were randomly selected from the questionnaire with frequent snoring line polysomnography (PSG).Results Five thousand and forty subjects (84.0%) had answered the questions, among which 4 045(80.23%) were available.When sleep apnea hypopnea index (AHI) ≥5 times/h, the lowest oxygen saturation (LSaO2) ≤0.94 was taken as the cut-point, the prevalence of OSAHS in children aged from 4 to 7 years in Putuo District of Shanghai was 3.91%.AHI strongly correlated with adenoidal hypertrophy ( partial correlation coefficient was 0.373).Each of the response such as questionnaire snoring , apnea, repeated reflexive, nocturia frequency and other options were assigned a numerical score from 0 to 4 and the questionnaire score and AHI showed a positive correlation(r=0.518).Among each option of the questionnaire , snoring and mouth breathing had a high sensitivity (95%, 87%) and general specificity (67%, 79%);apnea and arousal had a general sensitivity (66%, 29%) and a higher specificity (93%, 100%);nocturia and repeatedly turning option had no statistic significance (P>0.05).Conclusions The prevalence of children with OSAHS aged from 4 to 7 years in Putuo District of Shanghai was estimated to be 3.91%.Adenoid hypertrophy was one of the main causes .The questionnaire could be used for initial screening of OSAHS suspected cases in children and it had important reference value in the early diagnosis and treatment.
