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目的探讨儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)危险因素及其相关性。方法调查2013年6至12月于广东省东莞市人民医院健康体检的12~15岁儿童451例,进行夜间多导睡眠图(PSG)监测并测量体质量、体质量指数(BMI)、身高、颈围和颈长;记录遗传情况、呼吸暂停低通气指数(AHI)、睡眠打鼾次数和睡梦中肢体抽动比例等相关数据。根据国际儿童OSAHS标准分为OSAHS组和对照组,应用SPSS 21.0统计软件,采用Pearson相关性分析和多因素Logistic回归分析,分析肥胖与儿童OSAHS的发病和疾病严重程度的相关性。结果本研究共纳入451例儿童,其中OSAHS组86例,对照组365例,年龄为(13.67±0.60)岁,其中女童181(40.1%)例,男童270(59.9%)例。OSAHS组肥胖人数比例显著高于对照组(26.7%vs.3.6%,P<0.05)。另外OSAHS组的体质量、BMI、身高、AHI、睡眠打鼾比例、睡梦中肢体抽动比例、颈围和颈长比值均显著高于对照组,差异具有统计学意义(P<0.05)。AHI与BMI、打鼾、颈围、颈长以及颈围和颈长比值有显著相关性[BMI r=0.519(P<0.001)、肥胖r=0.408(P<0.001)、超重r=0.462(P<0.001)和颈围r=0.442(P<0.001)]。多因素Logistic回归分析显示,肥胖、睡眠打鼾和颈围是儿童OSAHS发生的独立危险因素,其中肥胖的危险系数最高(P<0.001,OR=3.778,95%CI=1.618~8.822)。结论肥胖、睡眠打鼾和颈围是导致儿童OSAHS的独立危险因素,并且肥胖程度与儿童OSAHS的疾病严重程度有密切关系。
Objective To investigate the risk factors and their correlation of childhood obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods 451 children aged 12-15 years old from Dongguan City People’s Hospital in Guangdong Province from June to December 2013 were investigated for PSG monitoring and body mass index, body mass index (BMI), height, Neck circumference and neck length; recorded genetic data, apnea-hypopnea index (AHI), number of sleep snoring and sleeping limb twitch ratio and other related data. The OSAHS group was divided into two groups: OSAHS group and control group. Pearson correlation analysis and multivariate Logistic regression analysis were used to analyze the correlation between obesity and OSAHS in children and the severity of the disease. Results A total of 451 children were enrolled in this study, including 86 OSAHS patients and 365 control patients with a mean age of (13.67 ± 0.60) years, of which 181 (40.1%) were girls and 270 (59.9%) were boys. The proportion of obesity in OSAHS group was significantly higher than that in control group (26.7% vs.3.6%, P <0.05). In addition, body mass, BMI, height, AHI, sleep snoring ratio, sleep-twitching limb twitch ratio, neck circumference and neck length ratio in OSAHS group were significantly higher than those in control group, with statistical significance (P <0.05). There was a significant correlation between AHI and BMI, snoring, neck circumference, neck length, neck circumference and neck length ratio (BMI r = 0.519, P <0.001) and obesity r = 0.408 0.001) and neck circumference r = 0.442 (P <0.001)]. Multivariate Logistic regression analysis showed that obesity, sleep snoring and neck circumference were independent risk factors for OSAHS in children, with the highest risk of obesity (P <0.001, OR = 3.778, 95% CI = 1.618-8.822). Conclusion Obesity, sleep snoring and neck circumference are independent risk factors for OSAHS in children, and the degree of obesity is closely related to the severity of OSAHS in children.