【摘要】 目的观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿潮气呼吸肺功能参数变化及其对多导睡眠图(PSG)结果的预测价值。方法选择OSAHS患儿68例,经整夜的PSG监测,根据PSG结果,分为PSG(+)组53例和PSG(-)组15例,计算呼吸紊乱指数(AHI)、呼吸暂停指数(AI)、低通气指数(HI)、最低血氧饱和度(LSaO2);对所有患儿行日间潮气呼吸肺功能检测,统计各组潮气量(VT/kg)、呼吸频率(RR)、吸气时间(TI)、呼气时间(TE)、吸呼比(TI/TE)、达峰时间(TPEF)、达峰时间比(TPEF/TE)、达峰容量(VPEF)、达峰容量比(VPEF/VE)、峰流速(PIEF)及分段的用力呼气流量(FEF25%、FEF50%、FEF75%)。结果PSG(+)组和PSG(-)组患儿VT/kg、TPEF、TPEF/TE、VPEF、VPEF/VE差异有统计学意义(P<0.01)。PSG(+)组的VT/kg明显降低,而TPEF、TPEF/TE、VPEF、VPEF/VE明显升高,各指标治疗后有不同程度改善。应用多元线性回归分析得出AHI的数值高低与VT/kg、TPEF、TPEF/TE、VPEF、VPEF/VE有相关关系。对PSG及肺功能两种检查方法行配对资料χ2检验示两种方法差异无统计学意义(χ2=3.5,P>0.05)。结论可以考虑将潮气呼吸肺功能作为儿童OSAHS的重要辅助检查方法之一,尤其是PSG检查前的筛查及对PSG阳性结果的预测,以探讨简便经济的筛查方法。更多还原

【Abstract】 Objective To investigate the pulmonary functional change of tidal respiration and its predictive value from the result of polysomnography(PSG) in children with obstructive sleep apnea hyperpnea syndrome(OSAHS).Methods Based on the overnight monitoring result of PSG,68 children with OSAHS were divided into two groups consisting of positive-PSG group(n = 53) and negative-PSG group(n = 15).Parameters of PSG including apnea hyperpnea index(AHI),apnea index(AI),hyperpnea index(HI) and lowest SaO2 were calculated.All patients in the two groups also received daytime testing of pulmonary function of tidal respiration,and the primary parameters were recorded including tidal volume/kg(VT/kg),respiratory rate(RR),inspiratory time(TI),expiratory time(TE),ratio of Ti /Te(TI /TE),peak tidal expiratory flow(PTEF),time to PTEF(TPEF),ratio of TPEF and total TE(TPEF /TE),expiratory volume at PTEF(VPEF),ratio of VPEF and total VE(VPEF /VE),TEF25% remaining,TEF50% remaining,and TEF75% remaining(TEF25%,TEF50%,TEF75%).Results VT /kg were significantly lower while TPEF,TPEF /TE,VPEF,VPEF /VE were obviously higher in positive-PSG group compared to those in negative-PSG group(P < 0.01 for all).The changes of parameters in positive-PSG group were improved to different extents after treat-ment.It was analyzed by multiple linear regression that AHI level was correlated with VT /kg,TPEF,TPEF /TE,VPEF and VPEF /VE.However,using matched-pair chi-square test,no significantly statistical difference was found between pulmonary function of tidal respiration and PSG for the assessment of OSAHS.Conclusions It is feasible that pulmonary function of tidal respiration,as a simple and economic method,can serve as one of the important examinations for the diagnosis of childhood OSAHS.In particular it can be used as preliminarily screening before PSG monitoring for predicting a positive outcome.更多还原