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目的:观察儿童哮喘特别是哮喘发作期夜间睡眠状态下的呼吸暂停和低通气现象。方法:73例小儿分为3组,其中哮喘组28例,阻塞性睡眠呼吸暂停低通气综合征(OSAHS)组30例,对照组15例,对3组的年龄、性别比、肥胖度及睡眠不良、鼾症、鼻塞、张口呼吸等一般资料进行了比较,并对3组的夜间多导睡眠仪(PSG)监测指标心率(HR)、呼吸(RR)、呼吸暂停指数(AI)、呼吸暂停低通气指数(AHI)、血氧饱和度(SpO2)、最低SpO2等进行了比较。结果:哮喘组、OSAHS组鼾症、鼻塞、张口呼吸、睡眠不良症状的比例与对照组相比显示出不同程度的差异(P<0.05),且哮喘组、OSAHS组间差异亦有统计学意义(P均<0.05)。哮喘组、OSAHS组AHI分别为46.23%、73.33%,对照组未见异常。哮喘组、OSAHS组RR、SpO2、最低SpO2、AI、AHA与对照组相比差异均有统计学意义(P<0.05),且哮喘组与OSAHS组间差异亦有统计学意义(P<0.05)。结论:PSG监测可显示哮喘发作期伴随睡眠期呼吸暂停低通气异常,这种呼吸异常的发生低于OSAHS组,而且程度相对较轻,对哮喘患儿实施PSG监测有助于管理夜间睡眠呼吸异常。
OBJECTIVE: To observe the phenomenon of apnea and hypoventilation in childhood asthma, especially during the nocturnal asthma attack. Methods: A total of 73 infants were divided into 3 groups: 28 in the asthma group, 30 in the obstructive sleep apnea-hypopnea syndrome group and 15 in the control group. The age, sex ratio, obesity and sleep Snoring, nasal obstruction, mouth breathing and other general data were compared. The indexes of heart rate (HR), respiration (RR), apnea index (AI), apnea index Low AHI, SpO2 and SpO2 were compared. Results: The rates of snoring, nasal obstruction, mouth breathing and poor sleep in asthma group and OSAHS group showed different degrees of difference compared with the control group (P <0.05), and the difference between the asthma group and the OSAHS group was also statistically significant (P <0.05). The AHI of asthma group and OSAHS group were 46.23% and 73.33% respectively, but there was no abnormality in the control group. The differences of RR, SpO2, lowest SpO2, AI and AHA between the asthma group and the OSAHS group were statistically significant (P <0.05), and the difference between the asthma group and the OSAHS group was also statistically significant (P <0.05) . CONCLUSIONS: PSG monitoring can show an episode of apnea-hypopnea associated with sleep apnea during asthma exacerbations, with a lower incidence of respiratory abnormality than OSAHS and to a lesser extent, and PSG monitoring in children with asthma contributes to management of nocturnal sleep apnea .