中国实用儿科杂志

中国实用儿科杂志

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儿童阻塞性睡眠呼吸暂停低通气综合征合并与不合并注意缺陷/多动障碍的多导睡眠图的比较

黄振云a,刘大波a,李志斌b,钟建文a,俞洁a,谭宗瑜a,孙昌志a,周丽枫a,陈倩a   

  1. 广州市儿童医院 a耳鼻咽喉科 b神经康复科，广东广州510120
  • 收稿日期:2006-10-20 修回日期:2007-01-15 出版日期:2007-04-06 发布日期:2007-04-06
  • 通讯作者: 刘大波

Comparison of the sleep architecture and principal variables of PSG study in children with OSAHS either with or without ADHD.

HUANG Zhen-yun，LIU Da-bo ，LI Zhi-bin，et al.   

  1. Otolaryngology Department,Guangzhou Children's Hospital,Department of Neurological Rehabilitation,Guangzhou 510120,China
  • Received:2006-10-20 Revised:2007-01-15 Online:2007-04-06 Published:2007-04-06

摘要： 目的通过对比合并与不合并注意缺陷多动障碍(ADHD)的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)儿童的多导睡眠监测指标，试图从睡眠结构和 睡眠主要参数的层次上来探讨ADHD的发病机制。 方法选择2004-01—2006-10于广州市儿童医院就诊的OSAHS患儿36例作为OSAHS组，合并有OSAHS的ADHD患儿20例作为观察组，选取无OSAHS及 ADHD的儿童30例作为对照组，三组之间在年龄、性别、体重指数等方面相比，差异无显著性。通过多导睡眠监测(PSG)，并由神经康复科专科医 生对其是否患有ADHD作出诊断。采用相应的统计学方法，对OSAHS组、观察组及对照组的睡眠结构进行比较，并对OSAHS组和观察组进行呼吸事 件及血氧状况的比较。 结果(1)与对照组相比，OSAHS组及观察组睡眠Ⅰ期增加，睡眠Ⅱ期、SWS及REM睡眠减少，差异有统计学意义(P<0.05)，OSAHS组的REM%为8.66± 3.94，观察组的REM%为5.65±5.41，REM%的改变有统计学意义(P<0.05)。(2)观察组儿童呼吸事件的次数与持续时间及血氧饱和度下降较OSAHS 儿童严重，差异有统计学意义(P<0.05)。 结论观察组儿童REM%及血氧饱和度的下降可能在ADHD的发病中起一定的作用。

关键词: 儿童, 注意力缺陷多动障碍, 阻塞性睡眠呼吸暂停低通气综合征, 多导睡眠图

Abstract: AbstractObjectiveTo compare the sleep architecture and principal variables of a PSG study carried out in children with either OSAHS or OSAHS+ADHD.The study is to evaluate the role of sleep architecture and principal variables of PSG study in pathogenesis of ADHD. MethodsThe sleep architecture were compared among the OSAHS group(n=36) and study group(OSAHS+ADHD,n=20) and control group (without OSAHS and ADHD,n=30).The respiratory events and SaO2 were compared between the study group and OSAHS group.All children underwent PSG montoring and diagnostic and statistical manual of mental disorder(DSM-Ⅳ) were used to diagnose whether children had ADHD or not. Results(1)The sleep architecture of children in study group and OSAHS group presented differences as compared to control group in an increase in the percentage of phase I sleep and a decrease in the percentage of phase Ⅱ sleep,SWS and REM sleep (P<0.05)The decrease of REM% was significant when compared between study group and OSAHS group(P<0.05).(2)The times and duration of respiratory events and decrease of SaO2 were severer than that in OSAHS group.The difference was significant (P<0.05). ConclusionThe decrease of REM% and SaO2 may play a role in pathogenesis of ADHD.

Key words: Polysomnography , Attention deficit hyperactivity disorder, Obstructive sleep apnea hypopnea syndrome