在阻塞性睡眠呼吸暂停中肺高血压的患病率及其与疾病严重程度的关系
Ian Milligan1,2, Anna Kate Shaw1,2, Roberta Leu1,3
1Children's Healthcare of Atlanta, Atlanta, Georgia.
概括
肺高血压 (PHTN) 在4.3%患有阻塞性睡眠呼吸暂停 (OSA) 的儿童中被发现. 在患有OSA的儿童中,PHTN与支气管肺功能障碍等并发症有关,而不是OSA的严重程度.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 睡眠医学 睡眠医学
- 呼吸系统医学 呼吸系统医学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 是儿童常见的疾病.
- 肺高血压 (PHTN) 是一种严重的并发症,可能来自各种疾病.
- 儿童群体中OSA严重程度和PHTN之间的关系需要进一步调查.
研究的目的:
- 为了确定诊断为OSA的儿童中PHTN的患病率.
- 评估心声回声学 (ECHO) 发现,表明该队列中存在PHTN.
- 探索PHTN与OSA的严重程度之间的相关性,包括低氧化和高心血压.
主要方法:
- 对患有OSA的儿科患者进行了回顾性队列研究.
- 纳入标准:多睡眠图和ECHO在30天内,没有心脏病.
- 基于特定ECHO参数的PHTN定义;与OSA严重性指标 (呼吸暂停-呼吸暂停指数,氧和度,潮尾二氧化碳) 的比较.
主要成果:
- 在509名研究患者中,PHTN的心声学证据在4.3%的患者中被发现.
- 没有发现OSA严重程度 (呼吸暂停-呼吸暂停指数,低氧化,高心脏) 和PHTN的ECHO参数之间的显著相关性.
- 伴随性疾病,如支气管肺功能障碍症 (OR 5.22),早产 (OR 3.10) 和自闭症 (OR 3.69),与增加PHTN的几率有关.
结论:
- 在患有OSA的儿童中,显著的百分比呈现PHTN的心声图征兆.
- 基于多睡眠仪数据的OSA严重程度似乎不是这个人群中PHTN的直接预测指标.
- 支气管肺功能障碍,早产和自闭症被确定为在患有OSA的儿童中发展PHTN的重要危险因素.
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