OSA—18量表評估兒童阻塞性睡眠呼吸暫停低通氣綜合征療效的可行性分析

潘永　范紹翀　鐘曉聲　葉浩昕　嚴睿成　戴智梅　王露斯

【摘要】 目的：探討兒童OSAHS特異性生活質量調查（Disease specific quality of for children with obstructive sleep apnea 18 items survey，OSA-18）量表評估兒童阻塞性睡眠呼吸暫停低通氣綜合征（Structive sleep apnea hypopnea syndrome，OSAHS）療效的可行性分析。方法：選取2015年5月-2016年12月于本院診治的輕度OSAHS患兒60例為研究對象，按照隨機數字表法將其分為藥物治療組和未用藥物組，各30例，藥物治療組給予局部內固醇噴鼻劑治療，未用藥物組不給予藥物治療，隨訪觀察3個月。治療前后均行多道睡眠描記術（Polysomnography，PSG）及采用OSA-18量表評估患兒的治療效果，分析輕度OSAHS兒童的呼吸暫停低通氣指數（Pnea hypopnea index，AHI）和最低血氧飽和度（Lowest oxygen saturation，LSaO2）與OSA-18評分的相關性。結果：治療后，藥物治療組AHI低于治療前及同期未用藥物組（P<0.05），藥物治療組LSaO2高于治療前及同期未用藥物組（P<0.05），未用藥物組AHI、LSaO2與治療前比較，差異均無統計學意義（P>0.05）；治療后，藥物治療組睡眠障礙、身體癥狀、對監護人影響及總分均低于治療前及同期未用藥物組，比較差異均有統計學意義（P<0.05），未用藥物組OSA-18各項指標評分和總分與治療前比較，差異均無統計學意義（P>0.05）；OSA-18各項指標評分及總分與AHI均呈正相關（P<0.05），除對監護人影響外，OSA-18其余各項指標評分及總分與LSaO2均呈負相關（P<0.05）。結論：OSA-18評分與PSG存在相關關系，可作為臨床評價兒童OSAHS的療效指標。

【關鍵詞】 OSA-18量表； 阻塞性睡眠呼吸暫停低通氣綜合征； 多道睡眠描記術

Feasibility Analysis of OSA-18 Questionnaire in Assessment Efficacy of Children with Structive Sleep Apnea Hypopnea Syndrome/PAN Yong，FAN Shaochong，ZHONG Xiaosheng，et al.//Medical Innovation of China，2017，14（32）：010-013

【Abstract】 Objective：To explore the feasibility analysis of disease specific quality of for children with obstructive sleep apnea 18 items survey（OSA-18） questionnaire in assessment efficacy of children with structive sleep apnea hypopnea syndrome（OSAHS）.Method：60 children with mild OSAHS diagnosed and treated in our hospital from May 2015 to December 2016 were selected，according to the random number table method，they were divided into drug treatment group and non medication group，30 cases in each group，the drug treatment group was given local steroid nasal spray，and non medication group was not given medication，followed up for 3 months.Before and after treatment，polysomnography（PSG） and OSA-18 questionnaire were used to evaluate the treatment effect，to analyze the correlation between pnea hypopnea index（AHI），lowest oxygen saturation（LSaO2） and OSA-18 questionnaire in mild OSAHS children.Result：After treatment，AHI in drug treatment group was lower than that of before treatment and the same period of without medication group（P<0.05），LSaO2 in drug treatment group was higher than that of before treatment and the same period of without medication group（P<0.05），AHI and LSaO2 in without medication group were compared with before treatment，the differences were not statistically significant（P>0.05）.After treatment，the sleep disorder，physical symptoms，the influence on guardian and total score of drug treatment group were lower than those of before treatment and the same period of without medication group，the differences were statistically significant（P<0.05），the each index OSA-18 score and the total score of without medication group were compared with before treatment，the differences were not statistically significant（P>0.05）.The scores and total scores of OSA-18 were positively correlated with AHI（P<0.05），besides the influence of the guardian，OSA-18 other indicators score and total score and LSaO2 were negatively correlated（P<0.05）.Conclusion：OSA-18 questionnaire has relationship with PSG，which can be used as a clinical evaluation of childrens OSAHS.endprint

【Key words】 OSA-18 questionnaire； Structive sleep apnea hypopnea syndrome； PSG

First-authors address：The Peoples Hospital of Zengcheng District，Guangzhou 511300，China

doi：10.3969/j.issn.1674-4985.2017.32.003

阻塞性睡眠呼吸暫停低通氣綜合征（Structive sleep apnea hypopnea syndrome，OSAHS）是兒童常見病，可影響患兒的代謝和睡眠質量，可導致認知和行為障礙、遺尿、血管內皮功能障礙，最終影響機體發育[1-2]。目前OSAHS的診斷和療效觀察主要依靠多道睡眠描記術（Polysomnography，PSG）監測相關客觀指標，但費用昂貴、耗時多，使臨床應用受到一定限制[3-4]。有報道顯示，兒童OSAHS特異性生活質量調查（Disease specific quality of for children with obstructive sleep apnea 18 items survey，OSA-18）量表可用來間接判斷OSAHS的嚴重程度和低氧血癥程度，具有良好的信度和效度，適用于兒童OSAHS患者生活質量的評價[5]。本研究擬采用……