Evaluation of behavioral change after adenotonsillectomy for obstructive sleep apnea in children with autism spectrum disorder
Evaluation of behavioral change after adenotonsillectomy for obstructive sleep apnea in children with autism spectrum disorder
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DOI：
10.1016/j.ridd.2017.04.012
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发表时间：
2017-06-01
影响因子：
3.1
通讯作者：
Taniike, Masako
中科院分区：
文献类型：
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作者：
Murata, Emi;Mohri, Ikuko;Taniike, Masako
背景与目的：阻塞性睡眠呼吸暂停（OSA）可能影响儿童的日常认知功能。我们研究的目的是双重的。第一个目的是利用儿童行为检查表（Child Behavior Checklist， CBCL）来检测腺扁桃体切除术（adenotonsillectomy， AT）治疗OSA是否能改善自闭症谱系障碍（autism spectrum disorder， ASD）儿童的行为。第二个目的是确定这些患有ASD的儿童在接受OSA治疗后行为改善的特征。方法：采用CBCL对5 ~ 14岁诊断为OSA的ASD患儿（30例）在AT前后的行为进行评价。无OSA的ASD患儿在两个时间点的CBCL评价为对照（n = 24）。我们对两组进行了统计检验。此外，我们进行了配对t检验来评估改善组和不变/恶化组之间CBCL tscore的变化，以确定可能影响OSA治疗后行为改变的特征。结果：经AT治疗后，OSA组CBCL量表t评分明显提高，对照组无明显变化。配对t检验显示，在接受OSA治疗的ASD合并OSA患儿中，改善组的CBCL预at得分显著高于未改变/恶化组。结论：ASD合并OSA患儿的行为问题在AT治疗后明显改善。早期发现和治疗阻塞性睡眠呼吸暂停儿童对于预防行为问题和支持智力发展至关重要。
Background and objective: Obstructive sleep apnea (OSA) may affect daily cognitive functioning in children. The aims of our study were two-fold. The first aim was to detect, using the Child Behavior Checklist (CBCL), whether adenotonsillectomy (AT) for the treatment of OSA improved the behavior of children with autism spectrum disorder (ASD). The second aim was to identify characteristics for behavioral improvement following the treatment of OSA in these children with ASD.Methods: The behaviors of ASD children aged 5-14 years diagnosed as having OSA (n = 30) were evaluated using CBCL before and after AT. CBCL evaluation of ASD children without OSA at two time points with the same interval served as a control (n = 24). We statistically examined the two groups. In addition, we conducted a paired t-test to assess changes in CBCL Tscores between the improved group and unchanged/deteriorated group to identify characteristics that may affect behavioral changes following OSA treatment.Results: After AT, T-scores of the CBCL scales were significantly improved in the OSA group, but no change was observed in the control. A paired t-test revealed that the improved group had significantly higher scores on the CBCL pre-AT than the unchanged/deteriorated group in ASD children with OSA after OSA treatment.Conclusions: Behavioral problems were significantly improved following AT in ASD children with OSA. Early detection and treatment of children with OSA is essential to prevent behavioral problems and to support mental development.