儿童哮喘合并阻塞性睡眠呼吸暂停低通气综合征高危人群的临床特点

doi:10.12372/jcp.2024.23e1164

临床儿科杂志 ›› 2024, Vol. 42 ›› Issue (11): 922-926.doi: 10.12372/jcp.2024.23e1164

儿童哮喘合并阻塞性睡眠呼吸暂停低通气综合征高危人群的临床特点

朱雯靓¹, 谷庆隆², 刘传合¹(), 沙莉¹, 黄贵民³, 陆颖霞², 赵京¹, 陈育智¹

1.首都儿科研究所附属儿童医院变态反应科，（北京 100020）
2.首都儿科研究所附属儿童医院耳鼻咽喉头颈外科，（北京 100020）
3.首都儿科研究所附属儿童医院儿童健康大数据研究中心（北京 100020）

收稿日期:2023-11-30 出版日期:2024-11-15 发布日期:2024-11-08
通讯作者: 刘传合 E-mail:liuchcip@126.com
基金资助:
首都儿科研究所青年科研基金项目(QN-2020-04);北京市医院管理中心项目(XTZD20180102);国家自然科学基金资助项目(72004142)

Characteristic of obstructive sleep apnea hypopnea syndrome high risk population in children with bronchial asthma

ZHU Wenjing¹, GU Qinglong², LIU Chuanhe¹(), SHA Li¹, HUANG Guimin³, LU Yingxia², ZHAO Jing¹, CHEN Yuzhi¹

1. Department of Allergy, Children’s Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China
2. Department of Otorhinolaryngology, Children’s Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China
3. Child Health Big Data Research Center, Children’s Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China

Received:2023-11-30 Online:2024-11-15 Published:2024-11-08
Contact: LIU Chuanhe E-mail:liuchcip@126.com

摘要/Abstract

摘要：

目的探讨儿童哮喘合并阻塞性睡眠呼吸暂停低通气综合征（OSAS）高危人群的临床特点。方法纳入2019年9月至2021年1月就诊的哮喘儿童进行问卷调查。根据问卷结果将哮喘儿童分成两组，分别为OSAS高危组和对照组，分析其临床特征。结果共纳入哮喘儿童200例，41.00%的哮喘儿童为OSAS高危人群。OSAS高危患儿哮喘未控制率明显增高（60.00%对36.25%，χ²=7.46，P=0.006）。OSAS高危患儿夜间哮喘发作与活动后哮喘发作情况均高于对照组，发生率分别为20.73%对6.78%，26.83%对13.56%（P<0.05）；同时OSAS高危患儿腺样体肥大发生率更高(35.37%对8.47%，P<0.05)，过敏性鼻炎症状如鼻塞、鼻痒、打喷、流涕评分更高（P<0.05）。结论哮喘合并OSAS高危患儿更容易出现哮喘控制欠佳、过敏性鼻炎症状重、腺样体肥大发生率高的情况。

关键词: 哮喘, 阻塞性睡眠呼吸暂停低通气综合征, 儿童

Abstract:

Objective This study aimed to explore the clinical characteristics of children with asthma who were at high risk of developing obstructive sleep apnea syndrome (OSAS). Methods A questionnaire survey among outpatient pediatric asthmatic children were conducted from September 2019 to January 2021. Children were categorized into an OSAS high-risk group and a control group based on responses to the questionnaire. Results A total of 200 asthmatic children were included, with 41.00% falling into the OSAS high-risk category. More uncontrolled asthmatic patients were found OSAS high-risk children (60.00% vs. 36.25%, χ²=7.46, P=0.006). Additionally, children in the OSAS high-risk group experienced a higher incidence of nocturnal asthma attacks (20.73% vs. 6.78%, P<0.05) and exercise-induced asthma symptoms (26.83% vs. 13.56%, P<0.05). The prevalence of adenoid hypertrophy was also greater in the OSAS high-risk group (35.37% vs. 8.47%, P<0.05), along with more severe symptoms of allergic rhinitis (P<0.05). Conclusion Children with asthma who are at high risk for OSAS are more likely to exhibit poorly controlled asthma, severe symptoms of allergic rhinitis, and a higher incidence of adenoid hypertrophy.

Key words: asthma, obstructive sleep apnea syndrome, child

朱雯靓, 谷庆隆, 刘传合, 沙莉, 黄贵民, 陆颖霞, 赵京, 陈育智. 儿童哮喘合并阻塞性睡眠呼吸暂停低通气综合征高危人群的临床特点[J]. 临床儿科杂志, 2024, 42(11): 922-926.

ZHU Wenjing, GU Qinglong, LIU Chuanhe, SHA Li, HUANG Guimin, LU Yingxia, ZHAO Jing, CHEN Yuzhi. Characteristic of obstructive sleep apnea hypopnea syndrome high risk population in children with bronchial asthma[J]. Journal of Clinical Pediatrics, 2024, 42(11): 922-926.

图/表 2

参考文献 24

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项目	OSAS高危组(n=82)	对照组(n=118)	统计量	P
年龄($\bar{x} \pm s$)/岁	6.96±2.00	7.70±2.10	t=2.44	0.016
男童[n(%)]	57(69.51)	81(68.64)	χ²=0.12	0.896
身高($\bar{x} \pm s$)/cm	127.32±14.10	130.76±13.60	t=1.74	0.084
体重($\bar{x} \pm s$)/kg	30.56±12.70	30.88±12.80	t=0.17	0.863
BMI[M(P₂₅~P₇₅)]/kg·m^-2	17.01(14.91~20.11)	16.47(14.68~19.04)	U=4 317.00	0.196

项目	OSAS高危组(n=82)	对照组(n=118)	统计量	P
哮喘日间>2次[n(%)]	21(25.61)	25(21.19)	χ²=0.53	0.465
夜间哮喘症状[n(%)]	17(20.73)	8(6.78)	χ²=8.61	0.003
哮喘活动受限[n(%)]	22(26.83)	16(13.56)	χ²=5.34	0.019
VAS评分[M(P₂₅~P₇₅)]
鼻塞	60(40~80)	30(0~50)	U=2 060.00	<0.001
鼻痒	40(5~70)	20(0~50)	U=3 036.50	0.003
喷嚏	30(10~50)	20(0~40)	U=3 045.50	0.003
流涕	20(0~60)	10(0~30)	U=2 833.50	<0.001

儿童哮喘合并阻塞性睡眠呼吸暂停低通气综合征高危人群的临床特点

Characteristic of obstructive sleep apnea hypopnea syndrome high risk population in children with bronchial asthma

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