儿童阻塞性睡眠呼吸暂停低通气综合征与炎症的关系

发布时间：2018-02-28 18:04

本文关键词： 睡眠呼吸暂停阻塞性腺样体/扁桃体肥大儿童投药鼻内糖皮质激素类白三烯受体拮抗剂　出处：《解放军医学杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的观察儿童轻中度阻塞性睡眠呼吸暂停低通气综合征(OS A H S)抗炎治疗的临床疗效,分析儿童OSAHS与炎症的关系。方法选取2016年1-11月经多导睡眠监测(PSG)确诊的轻中度OSAHS患儿50例,记录病史、腺样体大小、扁桃体大小、OSA-18问卷评分,给予糠酸莫米松鼻喷剂联合口服孟鲁司特治疗12周,治疗结束后复查PSG、腺样体大小、扁桃体大小及OSA-18问卷,并对治疗前后的数据进行比较。结果在50例患儿中,轻度OSAHS37例,中度OSAHS 13例;共治愈19例(38%),其中轻度OSAHS 17例,中度OSAHS 2例;显效14例(28%);有效5例(10%);总体有效率为76%(38/50)。与治疗前比较,轻度OSAHS患儿治疗后阻塞性呼吸暂停指数(OAI)、混合性呼吸暂停指数(MAI)降低,腺样体、扁桃体体积缩小,OSA-18评分降低,差异均有统计学意义(P0.05)。中度OSAHS患儿治疗后OAI较治疗前明显降低(P0.05),而腺样体、扁桃体体积及OSA-18评分、MAI与治疗前比较差异无统计学意义(P0.05)。扁桃体体积变化与PSG参数变化无明显相关性。结论抗炎治疗可明显改善OSAHS患儿的PSG指数、腺样体和扁桃体体积及生活质量,对轻度OSAHS患儿疗效更为显著。
[Abstract]:Objective to observe the clinical effect of anti-inflammatory therapy of mild to moderate obstructive sleep apnea hypopnea syndrome (OOS A H S) in children. Methods 50 children with mild to moderate OSAHS diagnosed by polysomnography from 2016 to November were selected to record the history, adenoid size, tonsil size and OSA-18 questionnaire. After 12 weeks of treatment with amethasone furoate nasal spray combined with oral montelukast, PSG, adenoid size, tonsil size and OSA-18 questionnaire were reviewed. Data before and after treatment were compared. 13 cases were moderate OSAHS, 19 cases were cured, 17 cases were mild OSAHS, 2 cases were moderate OSAHS, 14 cases had remarkable effect, 10 cases were effective, and the overall effective rate was 7638% 50%. After treatment, the obstructive apnea index (OPA) and the mixed apnea index (mai) were decreased, and the OSA-18 score of adenoids and tonsils were decreased. The difference was statistically significant (P 0.05). The OAI of moderate OSAHS patients was significantly lower than that of pre-treatment, while adenoids were found in children with moderate OSAHS. There was no significant difference in tonsil volume and OSA-18 score between before and after treatment (P 0.05). There was no significant correlation between tonsillar volume and PSG parameters. Conclusion Anti-inflammatory therapy can significantly improve the PSG index of children with OSAHS. The volume and quality of life of adenoids and tonsils were more effective in children with mild OSAHS.
【作者单位】：首都医科大学附属北京儿童医院耳鼻咽喉头颈外科;
【基金】：北京市医院管理局重点医学专业发展计划(ZYLX201508)~~
【分类号】：R766

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