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在患有1-3型脊髓肌缩症的儿童中,对呼吸器需求进行氧度和二氧化碳查
Archana Chacko1, Peter D Sly2, Robert S Ware3
1Centre for Child Health Research, University of Queensland, Brisbane, Australia.
Sleep medicine
|August 29, 2024
概括
氧气脱度指数 (ODI4) ≥20事件/小时有效选非侵入性通风 (NIV) 需要在未经治疗的脊髓肌缩 (SMA) 的儿童. 然而,TCCO2监测和氧度测量在接受疾病修饰性治疗 (DMT) 的儿童中是没有用处的.
科学领域:
- 儿科肺病学 儿科肺病学
- 神经肌肉疾病 神经肌肉疾病
- 睡眠医学 睡眠医学
背景情况:
- 脊髓肌缩症 (SMA) 的儿童通常需要辅助呼吸,即使有疾病修饰治疗 (DMT).
- 建议使用氧度和通过皮肤的二氧化碳 (TcCO2) 进行睡眠呼吸障碍 (SDB) 的查.
研究的目的:
- 评估脉冲氧计和TcCO2在SDB查中的有效性,以及在SMA类型1-3的儿童中对非侵入性通风 (NIV) 的需要.
- 评估这些查方法的诊断准确性,与多睡眠学 (PSG) 相比.
主要方法:
- 一项前性队列研究涉及47名未接受治疗和36名接受治疗的儿童在澳大利亚昆士兰州SMA (类型1-3).
- 进行了全面的诊断性多睡眠图 (PSG),抽取了脉冲氧计和TcCO2数据.
- 计算了接收器操作特征 (ROC) 曲线和诊断统计数据,以评估选效用.
主要成果:
- 在未接受治疗的儿童中,氧气不和指数≥4% (ODI4) ≥20次/小时显示了82.6%的灵敏度来预测NIV需求.
- 单独或与氧度计相结合的TCCO2监测在未治疗和治疗组中显示出低诊断能力.
- 对接受DMT的儿童来说,氧度和TcCO2监测不是有用的查测试.
结论:
- ODI4 ≥20事件/小时可以预测未经治疗的SMA儿童需要NIV.
- TcCO2监测没有改善NIV需要的积极预测值.
- 即使正常查结果也可能仍然需要诊断PSG;在接受DMT治疗的儿童中,查是无效的.
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