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复发性喘息/哮喘儿童的睡眠呼吸障碍:一项单中心研究

Sleep-Disordered Breathing in Children with Recurrent Wheeze/Asthma: A Single Centre Study.

作者信息

Zaffanello Marco, Gasperi Emma, Tenero Laura, Piazza Michele, Pietrobelli Angelo, Sacchetto Luca, Antoniazzi Franco, Piacentini Giorgio

机构信息

Department of Surgery, Dentistry, Paediatrics and Gynaecology, Pediatric Division, University of Verona, Piazzale L.A. Scuro, 10, 37134 Verona, Italy.

Department of Surgery, Dentistry, Paediatrics and Gynaecology, Otorhinolaryngology Unit, University of Verona, 37134 Verona, Italy.

出版信息

Children (Basel). 2017 Nov 14;4(11):97. doi: 10.3390/children4110097.

Abstract

The relationship between asthma and sleep-disordered breathing is bidirectional due to common risk factors that promote airway inflammation. Obstructive sleep-disordered breathing and recurrent wheeze/asthma are conditions that involve the upper and the lower respiratory system, respectively. The aim of the present study was to investigate the sleep disordered breathing in children with recurrent wheeze/asthma. This was a retrospective study concerning children older than 2 years who underwent-between January 2014 and November 2016-an in-laboratory overnight polygraphic study. We match the children between those who do or do not have recurrent wheeze/asthma disease. We examined the clinical records of 137 children. We excluded eight patients because of neurological and genetic conditions. Children with recurrent wheeze/asthma ( = 28) were younger ( = 0.002) and leaner ( = 0.013) compared to non-affected children ( = 98). Children with wheeze/asthma and unaffected ones had a similar obstructive apnea-hypopnea index ( = 0.733) and oxygen desaturation index ( = 0.535). The logistic regression analysis, in which the condition of wheeze/asthma (yes/no) was a dependent variable, while demographic (age, sex, body mass index (BMI) -score) and polygraphic results during sleep (obstructive apnea-hypopnea index, central apnea index, peripheral oxygen saturation (SpO₂), and snoring) were covariates, showed that children with wheeze/asthma had higher central apnea index (Exp(B) = 2.212; Wald 6.845; = 0.009). In conclusion, children with recurrent wheeze/asthma showed an increased number of central sleep apneas than unaffected children. This finding may suggest a dysfunction of the breathing control in the central nervous system during sleep. Systemic or central inflammation could be the cause.

摘要

由于促进气道炎症的共同风险因素,哮喘与睡眠呼吸障碍之间的关系是双向的。阻塞性睡眠呼吸障碍和复发性喘息/哮喘分别涉及上呼吸道和下呼吸道。本研究的目的是调查复发性喘息/哮喘儿童的睡眠呼吸障碍情况。这是一项回顾性研究,对象为2014年1月至2016年11月期间在实验室进行过夜多导睡眠图研究的2岁以上儿童。我们将有或没有复发性喘息/哮喘疾病的儿童进行匹配。我们检查了137名儿童的临床记录。由于神经和遗传疾病,我们排除了8名患者。与未受影响的儿童(n = 98)相比,复发性喘息/哮喘儿童(n = 28)更年轻(P = 0.002)且更瘦(P = 0.013)。有喘息/哮喘的儿童和未受影响的儿童具有相似的阻塞性呼吸暂停低通气指数(P = 0.733)和氧饱和度下降指数(P = 0.535)。在逻辑回归分析中,喘息/哮喘状况(是/否)为因变量,而人口统计学因素(年龄、性别、体重指数(BMI) -评分)和睡眠期间的多导睡眠图结果(阻塞性呼吸暂停低通气指数、中枢性呼吸暂停指数、外周血氧饱和度(SpO₂)和打鼾)为协变量,结果显示有喘息/哮喘的儿童中枢性呼吸暂停指数更高(Exp(B)=2.212;Wald 6.845;P = 0.009)。总之,复发性喘息/哮喘儿童的中枢性睡眠呼吸暂停次数比未受影响的儿童增加。这一发现可能表明睡眠期间中枢神经系统呼吸控制功能障碍。全身或中枢炎症可能是原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8a4/5704131/2f26ba94a6d5/children-04-00097-g001.jpg

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