睡眠呼吸障碍对儿童身高、体重和认知功能的影响
发布时间：2019-05-19 16:41
【摘要】：目的通过对比分析学龄前期和学龄期儿童的生长发育指标、认知测试得分,以期找到睡眠呼吸障碍(SDB)对不同年龄段儿童身高、体重及认知功能影响的客观证据,探讨其发病机制,为改善患儿生存及生活质量的最佳干预方式提供依据。 方法从2009年11月～2011年2月因夜间睡眠打鼾、张口呼吸伴或不伴憋气,在宁夏医科大学附属医院耳鼻咽喉头颈外科住院治疗并进行多导睡眠监测的儿童中,随机抽取129例,其中男94例,女35例,年龄4～12岁。将129例研究对象进行两次不同的分组:①根据不同年龄段的患儿认知测试使用的量表不同,将129例研究对象分为学龄前期组和学龄期组;符合学龄前期组的患儿68例,学龄期组的患儿61例;②根据儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)、原发性打鼾(PS)的诊断标准,分别将学龄前期组和学龄期组的儿童分为OSAHS组和PS组。分期对比分析OSAHS组和PS组的身高、体重、体质量指数(BMI)。从当地幼儿园、小学中随机选取同期无睡眠打鼾、张口呼吸、憋气等症状并符合本研究排除标准的健康儿童60例为对照组,其中学龄前期和学龄期各30例,其年龄、性别、身高、体重及其来源均与研究组相似。应用中国韦氏幼儿及儿童智力量表及划销测验,记录OSAHS组和PS组的测试结果,并与同期的正常儿童作对照;应用SPSS16.0统计软件包进行统计分析。 结果⑴身高、体重①学龄前期OSAHS组、PS组在年龄构成、男女比例上差异无统计学意义(P0.05),两组的体重相比无显著性差异(P0.05);OSAHS组的身高低于PS组、BMI高于PS组,均有显著性差异(P0.01)。②学龄期OSAHS组、PS组在年龄构成、男女比例上差异无统计学意义(P0.05),两组的身高相比无显著性差异(P0.05);OSAHS组的体重、BMI高于PS组,有显著差异(P0.01)。⑵学龄前期和学龄期OSAHS组和PS组的慢波睡眠期(SWS)和快速动眼睡眠期(REM)占睡眠时间百分比无显著差异(P0.05);OSAHS组阻塞性呼吸暂停指数(OAI)、呼吸暂停低通气指数(AHI)均明显高于PS组(P0.01),最低血氧饱和度(SaO2)明显低于PS组(P0.01)。⑶认知功能①学龄前期OSAHS组、PS组、正常对照组三组之间言语智商(VIQ)、操作智商(PIQ)、总智商(FIQ)测定结果比较,OSAHS组VIQ、FIQ均明显低于对照组及PS组,差异有统计学意义(P0.01);PS组的VIQ、PIQ、FIQ与对照组相比,差异无统计学意义(P0.05);在智力测验各分测验比较中,OSAHS组与PS组相比在言语量表的四个分测验知识、算术、图片概括、领悟及操作量表分测验动物下蛋的得分较低(P0.05),其他分测验无显著性差异(P0.05);OSAHS组与对照组相比,除几何图形这一分测验的得分无显著性差异,余十项测试均低于对照组(P0.05);PS组与对照组相比,在算术、动物下蛋、图画填充、迷津的得分较低,差异有统计学意义(P0.05)。②学龄期OSAHS组PIQ、FIQ均低于对照组及PS组,差异有统计学意义(P0.05);PS组VIQ、PIQ、FIQ与对照组相比,无统计学差异(P0.05);在各分测验中,OSAHS组与PS组相比在操作量表的分测验图片排列、木块图案、编码的得分较低,差异有统计学意义(P0.01),在其他分测验中无显著性差异(P0.05);OSAHS组与对照组相比,除数字广度这一分测验的得分无显著性差异,余十项分测验均低于对照组(P0.05);PS组与对照组相比,在分类、词汇、领悟、图片排列上差异有统计学意义(P0.05)。③三组间注意力测试结果的比较OSAHS组的失误率高于PS组(P0.05);和对照组相比,OSAHS组、PS组失误率均明显增高(P0.01)。 结论⑴儿童OSAHS对学龄前儿童的身高、学龄儿童的体重有明显影响,SDB可影响儿童的生长发育;⑵学龄前期与学龄期OSAHS组与PS组的睡眠结构无明显差异;⑶学龄前期和学龄期SDB儿童均已出现多种认知功能方面的缺陷,SDB可导致认知功能的损害、影响儿童智力发育,应尽早采取干预措施以保障儿童健康成长。
[Abstract]:Objective To study the effect of sleep disordered breathing (SDB) on the height, weight and cognitive function of children in different age groups by comparing the growth and development indexes and the cognitive test scores of the children in the pre-school and the early stage. And provides the basis for improving the survival and quality of life of the child. Methods 129 cases were randomly selected from November,2009 to February,2011 for nocturnal sleep snoring, open-mouth breathing with or without breathing, and 129 cases were randomly selected in the children with otorhinolaryngology and head-neck surgery in the Affiliated Hospital of Ningxia Medical University, including 94 males and 35 females. Example, Age 4-12 A total of 129 subjects were divided into two different groups:1. According to the scales used in the cognitive test of the children of different age groups,129 subjects were divided into the pre-school group and the pre-school group;68 of the children who met the pre-school group and 61 of the children with the same age group Example: Children were divided into OSAHS group and PS group respectively according to the diagnosis criteria of children's obstructive sleep apnea-hypopnea syndrome (OSAHS) and primary snoring (PS). The height, body weight, body mass index (BMI) of the OSAHS group and the PS group were analyzed by stages. ).60 healthy children were randomly selected from the local kindergartens and primary schools for the same period without sleep snoring, open-mouth breathing, and breath-holding, and were in accordance with the exclusion criteria of the study. High, body weight and its source are in phase with the study group The test results of the OSAHS group and the PS group were recorded and compared with the normal children in the same period. The SPSS16.0 statistical software package was used for statistical analysis. The results showed that there was no significant difference between the two groups (P0.05). The difference between the two groups was not significant (P0.05). The height of the OSAHS group was lower than that of the PS group, and the BMI was higher than that of the PS group (P <0.05). There was no significant difference between the two groups (P0.05). The body weight and BMI of the OSAHS group were higher than that of the PS group (P0.05). (01) The slow-wave sleep period (SWS) and fast-moving-eye sleep (REM) of the OSAHS group and the PS group in the first and the second stage were significantly higher than those in the PS group (P0.05); the obstructive sleep apnea index (OAI) and the apnea-hypopnea index (AHI) in the OSAHS group were significantly higher than those in the PS group (P0. 01) The minimum oxygen saturation (SaO2) was significantly lower than that of the PS group (P0. Results Compared with the control group and the PS group, the VIQ and FIQ of the OSAHS group were significantly lower than that in the control group and the PS group (P0.01). The VIQ of the PS group was significantly lower than that of the control group and the PS group. Compared with the control group, the difference of PIQ and FIQ was not significant (P0.05); in the comparison of the subtest of the intelligence test, the scores of the four sub-test knowledge, arithmetic, picture summarization, comprehension and operation scale of the OSAHS group and the PS group in the speech scale were lower (P0. (05) There was no significant difference in other subtests (P0.05). There was no significant difference in the score of the subtest in the OSAHS group and the control group, and the remaining ten tests were lower than that of the control group (P0.05). Compared with the control group, the scores of the remaining ten tests were lower than that of the control group (P0.05); the PS group and the control group were in arithmetic, the eggs in the animals, the pictures were filled, and the maze was obtained. The difference was lower and the difference was significant (P0. Results The PIQ and FIQ of the OSAHS group were lower than that in the control group and the PS group (P <0.05). Compared with the control group, there was no statistical difference (P <0.05). In each subtest, the scores of the OSAHS group and the PS group were compared with the control group, and there was no statistical difference (P0.05); in each subtest, the OSAHS group and the PS group were arranged in the sub-test pictures of the operation scale, and the wood The scores of the block pattern and the coding were lower, the difference was significant (P0.01), and there was no significant difference in the other subtests (P0.05); the scores of the OSAHS group and the control group did not differ significantly, and the remaining ten subscores were lower than that of the control group (P0. (05) Compared with the control group, the difference of the group, the vocabulary, the comprehension and the picture arrangement was statistically significant (P0. Compared with the control group, the error rate of OSAHS group was higher than that in PS group (P0.05). Conclusion The OSAHS of preschool children has a significant effect on the height of preschool children and the weight of school-age children, and SDB can affect the growth and development of children. There is no obvious difference; in the pre-school and in the early stage, SDB children have various cognitive functions, SDB can lead to the impairment of cognitive function and affect the intelligence development of children, and the intervention measures should be taken as early as possible to guarantee the children
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R766
本文编号：2480883
[Abstract]:Objective To study the effect of sleep disordered breathing (SDB) on the height, weight and cognitive function of children in different age groups by comparing the growth and development indexes and the cognitive test scores of the children in the pre-school and the early stage. And provides the basis for improving the survival and quality of life of the child. Methods 129 cases were randomly selected from November,2009 to February,2011 for nocturnal sleep snoring, open-mouth breathing with or without breathing, and 129 cases were randomly selected in the children with otorhinolaryngology and head-neck surgery in the Affiliated Hospital of Ningxia Medical University, including 94 males and 35 females. Example, Age 4-12 A total of 129 subjects were divided into two different groups:1. According to the scales used in the cognitive test of the children of different age groups,129 subjects were divided into the pre-school group and the pre-school group;68 of the children who met the pre-school group and 61 of the children with the same age group Example: Children were divided into OSAHS group and PS group respectively according to the diagnosis criteria of children's obstructive sleep apnea-hypopnea syndrome (OSAHS) and primary snoring (PS). The height, body weight, body mass index (BMI) of the OSAHS group and the PS group were analyzed by stages. ).60 healthy children were randomly selected from the local kindergartens and primary schools for the same period without sleep snoring, open-mouth breathing, and breath-holding, and were in accordance with the exclusion criteria of the study. High, body weight and its source are in phase with the study group The test results of the OSAHS group and the PS group were recorded and compared with the normal children in the same period. The SPSS16.0 statistical software package was used for statistical analysis. The results showed that there was no significant difference between the two groups (P0.05). The difference between the two groups was not significant (P0.05). The height of the OSAHS group was lower than that of the PS group, and the BMI was higher than that of the PS group (P <0.05). There was no significant difference between the two groups (P0.05). The body weight and BMI of the OSAHS group were higher than that of the PS group (P0.05). (01) The slow-wave sleep period (SWS) and fast-moving-eye sleep (REM) of the OSAHS group and the PS group in the first and the second stage were significantly higher than those in the PS group (P0.05); the obstructive sleep apnea index (OAI) and the apnea-hypopnea index (AHI) in the OSAHS group were significantly higher than those in the PS group (P0. 01) The minimum oxygen saturation (SaO2) was significantly lower than that of the PS group (P0. Results Compared with the control group and the PS group, the VIQ and FIQ of the OSAHS group were significantly lower than that in the control group and the PS group (P0.01). The VIQ of the PS group was significantly lower than that of the control group and the PS group. Compared with the control group, the difference of PIQ and FIQ was not significant (P0.05); in the comparison of the subtest of the intelligence test, the scores of the four sub-test knowledge, arithmetic, picture summarization, comprehension and operation scale of the OSAHS group and the PS group in the speech scale were lower (P0. (05) There was no significant difference in other subtests (P0.05). There was no significant difference in the score of the subtest in the OSAHS group and the control group, and the remaining ten tests were lower than that of the control group (P0.05). Compared with the control group, the scores of the remaining ten tests were lower than that of the control group (P0.05); the PS group and the control group were in arithmetic, the eggs in the animals, the pictures were filled, and the maze was obtained. The difference was lower and the difference was significant (P0. Results The PIQ and FIQ of the OSAHS group were lower than that in the control group and the PS group (P <0.05). Compared with the control group, there was no statistical difference (P <0.05). In each subtest, the scores of the OSAHS group and the PS group were compared with the control group, and there was no statistical difference (P0.05); in each subtest, the OSAHS group and the PS group were arranged in the sub-test pictures of the operation scale, and the wood The scores of the block pattern and the coding were lower, the difference was significant (P0.01), and there was no significant difference in the other subtests (P0.05); the scores of the OSAHS group and the control group did not differ significantly, and the remaining ten subscores were lower than that of the control group (P0. (05) Compared with the control group, the difference of the group, the vocabulary, the comprehension and the picture arrangement was statistically significant (P0. Compared with the control group, the error rate of OSAHS group was higher than that in PS group (P0.05). Conclusion The OSAHS of preschool children has a significant effect on the height of preschool children and the weight of school-age children, and SDB can affect the growth and development of children. There is no obvious difference; in the pre-school and in the early stage, SDB children have various cognitive functions, SDB can lead to the impairment of cognitive function and affect the intelligence development of children, and the intervention measures should be taken as early as possible to guarantee the children
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R766
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