中华耳鼻咽喉头颈外科杂志
中華耳鼻嚥喉頭頸外科雜誌
중화이비인후두경외과잡지
CHINESE JOURNAL OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY
2013年
6期
507-510
,共4页
沈翎%许杨杨%林宗通%杨中婕
瀋翎%許楊楊%林宗通%楊中婕
침령%허양양%림종통%양중첩
睡眠呼吸暂停,阻塞性%儿童%鼻疾病%呼吸道感染
睡眠呼吸暫停,阻塞性%兒童%鼻疾病%呼吸道感染
수면호흡잠정,조새성%인동%비질병%호흡도감염
Sleep apnea,obstructive%Child%Nose diseases%Respiratory tract infections
目的 探讨儿童阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)与鼻部疾病的关系.方法 选择2008年6月至2010年10月期间,在门诊和病房以多道睡眠图(polysomnography,PSG)检查确诊的338例OSAHS患儿为病例组,并根据阻塞性呼吸暂停指数(obstructive apnea index,OAI)或呼吸暂停低通气指数(apnea hypoventilation index,AHI)分为轻、中、重3个亚组,同时采用简单随机抽样方法,选择同期就诊的无上呼吸道阻塞症状的207例声带小结患儿为对照组.对两组患儿每年上呼吸道感染次数以及血清总IgE(total IgE,tIgE)、特异性IgE(specific IgE,sIgE)、电子鼻咽喉镜和鼻窦CT的检查结果进行回顾性分析,探讨儿童OSAHS与鼻部疾病的相关性.以SPSS 17.0软件对数据进行统计学分析.结果 病例组每年上呼吸道感染次数、血清tIgE阳性比例、鼻-鼻窦炎、鼻腔狭窄的比例分别为(8.7±5.7)次、60.9％、79.9％、50.0％,均明显高于对照组的(4.4±2.6)次、32.8％、12.1％、6.3％,差异有统计学意义(t=7.578,x2值分别为41.943、237.704、110.322,p值均＜0.01).多因素回归分析显示,鼻腔狭窄、鼻-鼻窦炎为儿童OSAHS的主要危险因素(OR值分别为16.008、4.671,P值均＜0.01),二者对儿童OSAHS存在联合作用(OR=113.430,P＜0.01).鼻-鼻窦炎、鼻腔狭窄在病例组轻、中、重3个亚组中呈逐渐增加趋势(x2值分别为21.571、17.304,P值均＜0.01).结论 上呼吸道感染和变态反应因素为儿童OSAHS的危险因素.鼻-鼻窦炎、鼻腔狭窄为儿童OSAHS的主要危险因素,并与OSAHS病情严重程度呈正相关.
目的 探討兒童阻塞性睡眠呼吸暫停低通氣綜閤徵(obstructive sleep apnea hypopnea syndrome,OSAHS)與鼻部疾病的關繫.方法 選擇2008年6月至2010年10月期間,在門診和病房以多道睡眠圖(polysomnography,PSG)檢查確診的338例OSAHS患兒為病例組,併根據阻塞性呼吸暫停指數(obstructive apnea index,OAI)或呼吸暫停低通氣指數(apnea hypoventilation index,AHI)分為輕、中、重3箇亞組,同時採用簡單隨機抽樣方法,選擇同期就診的無上呼吸道阻塞癥狀的207例聲帶小結患兒為對照組.對兩組患兒每年上呼吸道感染次數以及血清總IgE(total IgE,tIgE)、特異性IgE(specific IgE,sIgE)、電子鼻嚥喉鏡和鼻竇CT的檢查結果進行迴顧性分析,探討兒童OSAHS與鼻部疾病的相關性.以SPSS 17.0軟件對數據進行統計學分析.結果 病例組每年上呼吸道感染次數、血清tIgE暘性比例、鼻-鼻竇炎、鼻腔狹窄的比例分彆為(8.7±5.7)次、60.9％、79.9％、50.0％,均明顯高于對照組的(4.4±2.6)次、32.8％、12.1％、6.3％,差異有統計學意義(t=7.578,x2值分彆為41.943、237.704、110.322,p值均＜0.01).多因素迴歸分析顯示,鼻腔狹窄、鼻-鼻竇炎為兒童OSAHS的主要危險因素(OR值分彆為16.008、4.671,P值均＜0.01),二者對兒童OSAHS存在聯閤作用(OR=113.430,P＜0.01).鼻-鼻竇炎、鼻腔狹窄在病例組輕、中、重3箇亞組中呈逐漸增加趨勢(x2值分彆為21.571、17.304,P值均＜0.01).結論 上呼吸道感染和變態反應因素為兒童OSAHS的危險因素.鼻-鼻竇炎、鼻腔狹窄為兒童OSAHS的主要危險因素,併與OSAHS病情嚴重程度呈正相關.
목적 탐토인동조새성수면호흡잠정저통기종합정(obstructive sleep apnea hypopnea syndrome,OSAHS)여비부질병적관계.방법 선택2008년6월지2010년10월기간,재문진화병방이다도수면도(polysomnography,PSG)검사학진적338례OSAHS환인위병례조,병근거조새성호흡잠정지수(obstructive apnea index,OAI)혹호흡잠정저통기지수(apnea hypoventilation index,AHI)분위경、중、중3개아조,동시채용간단수궤추양방법,선택동기취진적무상호흡도조새증상적207례성대소결환인위대조조.대량조환인매년상호흡도감염차수이급혈청총IgE(total IgE,tIgE)、특이성IgE(specific IgE,sIgE)、전자비인후경화비두CT적검사결과진행회고성분석,탐토인동OSAHS여비부질병적상관성.이SPSS 17.0연건대수거진행통계학분석.결과 병례조매년상호흡도감염차수、혈청tIgE양성비례、비-비두염、비강협착적비례분별위(8.7±5.7)차、60.9％、79.9％、50.0％,균명현고우대조조적(4.4±2.6)차、32.8％、12.1％、6.3％,차이유통계학의의(t=7.578,x2치분별위41.943、237.704、110.322,p치균＜0.01).다인소회귀분석현시,비강협착、비-비두염위인동OSAHS적주요위험인소(OR치분별위16.008、4.671,P치균＜0.01),이자대인동OSAHS존재연합작용(OR=113.430,P＜0.01).비-비두염、비강협착재병례조경、중、중3개아조중정축점증가추세(x2치분별위21.571、17.304,P치균＜0.01).결론 상호흡도감염화변태반응인소위인동OSAHS적위험인소.비-비두염、비강협착위인동OSAHS적주요위험인소,병여OSAHS병정엄중정도정정상관.
Objective To explore the relationship between children obstructive sleep apnea hypopnea syndrome (OSAHS) and nasal diseases.Methods Three hundred and thirty-eight cases of pediatric OSAHS confirmed by polysomnography (PSG) had been enrolled as the treatment group,and divided into mild subgroup,moderate subgroup and severe subgroup according to the obstructive apnea index (OAI) and apnea hypoventilation index (AHI).The other two hundred and seven pediatric vocal cord nodule cases without OSAHS had been randomly selected as the control group.The retrospective analysis of upper respiratory tract infection frequency per year,expression levels of total IgE (tIgE) and allergenspecific IgE (slgE),results of electronic nasopharyngoscope test and nasal sinus CT scans had been performed in all the pediatric cases.The data were analyzed by SPSS 17.0.Results The upper respiratory tract infection frequency per year,ratio of cases with positive results of tlgE,ratio of cases with nasosinusitis,ratio of cases with narrow nasal cavity in the cxperiment group were respectively 8.7 ± 5.7,60.9％,79.9％ and 50.0％,while those in the control group were respectively 4.4 ± 2.6,32.8％,12.1％ and 6.3％,with significant difference between groups (t =7.578,x2 value was 41.943,237.704,110.322,all P ＜ 0.01).The multiple regression analysis indicated that,nasosinusitis and narrow nasal cavity were the two major risk factors of pediatric OSAHS (OR1 =16.008,OR2 =4.671,all P ＜ 0.01),with combined effects(OR =113.430,P ＜ 0.01).The rank test analysis in term of risk factors of severity of OSAHS had indicated that,prevalence of nasosinusitis and narrow nasal cavity were increased as risingseverity of OSAHS (x12 =21.571,x22 =17.304,all P ＜0.01).Conclusions Infection and allergy are risk factors of pediatric OSAHS.Nasosinusitis and narrow nasal cavity are two major risk factors of pediatric OSAHS,which have positive relationship with the severity of OSAHS.
