临床误诊误治

目的探讨多导睡眠监测儿童睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OS-AHS)的诊断价值。方法选择我院明确诊断为OSAHS患儿52例,按呼吸暂停低通气指数(AHI)分为轻度组、中度组、重度组并行多导睡眠监测,观察比较3组平均血氧饱和度(SaO2)、最低SaO2(LSaO2)、≥3%氧减指数(ODI)、SaO2≤92%时间、体重指数(BMI),并分析这些指标与AHI的相关性。结果 3组≥3%ODI、SaO2≤92%时间比较,轻度组<中度组<重度组,且差异均有统计学意义(P<0.01);平均SaO2、LSaO2、BMI比较差异均无统计学意义(P>0.05)。本研究中儿童AHI与≥3%ODI呈高度正相关(r=0.652,P=0.00),与平均SaO2、LSaO2、SaO2≤92%时间及BMI均无相关性(r=-0.297,P=0.60;r=-0.269,P=0.10;r=0.132,P=0.25;r=0.105,P=0.28)。结论相对于其他通气指标,ODI对判断儿童OSAHS严重程度有更好的临床指导意义。

Objective To investigate the diagnostic value of polysomnography(PSG) in children obstructive sleep apnea hypopnea syndrome(OSAHS) in children.Methods 52 patients diagnosed as having OSAHS were enrolled in our study.According to the apnea-hypopnea index(AHI),they were divided into mild group,moderate group and severe group,and all underwent polysomnography.The average SaO2,lowest SaO2,≥3% ODI,time of SaO2 ≤92% and BMI were observed,and the relationship between these indicators and AHI were analysed.Results The times of SaO2 ≤92% and ≥3%ODI were compared,the data were distributed as mild group< moderate group < severe group with significant difference(P<0.01);There were no statistical difference in average SaO2,lowest SaO2 and BMI among the 3 groups(P>0.05).In this study,AHI and ≥ 3% ODI of children were positively correlated(r=0.652,P=0.00),AHI and average SaO2,lowest SaO2,time of SaO2≤92% and BMI children was not correlated(r=-0.297,P=0.60;r=-0.297,P=0.60;r=0.132,P=0.25;r=0.105,P=0.28,respectively).Conclusion Compared with other ventilation indexes,ODI is more reliable in diagnosing the severity of OSAHS in children.