Endothelial Function in Children With OSA and the Effects of Adenotonsillectomy
Endothelial Function in Children With OSA and the Effects of Adenotonsillectomy
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DOI：
10.1378/chest.14-1307
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发表时间：
2015-01-01
期刊：
影响因子：
9.6
通讯作者：
Li, Albert Martin
中科院分区：
文献类型：
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作者：
Chan, Kate C. C.;Au, Chun T.;Li, Albert Martin
背景技术背景：儿童OSA和内皮功能之间的关联（通过血流介导的舒张（FMD）测量）及其对OSA治疗的反应尚不确定。本研究的目的是比较FMD在儿童OSA与非打鼾对照subjects，并检查其对treatment.METHODS的反应：索引病例是6至18岁的儿童与习惯性打鼾和多导睡眠图（PSG）证实的OSA（阻塞性呼吸暂停低通气指数[OAHI] > 1事件/小时）。每个病例都与一个年龄、性别和BMI匹配的无打鼾对照组配对，对照组是从我们以前的社区生长调查中招募的。所有受试者在夜间PSG后的早晨进行FMD测量。向满足预定义的AT手术标准的受试者提供腺样体扁桃体切除术（AT）。所有病例均于6个月后复查PSG和FMD。与对照组相比，OSA组的OAHI（中位数，5.3起事件/h [四分位距（IQR），2.6-11.7] vs 0.2起事件/h [IQR，0-0.5]，P <0.001）和FMD（平均值+/- SD，7.9% +/- 1.3% vs 8.3% +/- 0.8%; P = 0.04）明显更高。32例受试者接受了AT。AT组的OAHI显著降低（-8.8起事件/h [IQR，-13.7至-4.7]; P < .001），伴随FMD显著增加（+ 0.6% [IQR，0.4-1.4]; P < .001），这在未接受AT的受试者中未观察到。患有OSA的儿童FMD减少，这是可逆的治疗。
BACKGROUND: The association between childhood OSA and endothelial function as measured by flow-mediated dilation (FMD) and its response to OSA treatment are uncertain. The objective of this study was to compare FMD in children with OSA with nonsnoring control subjects and to examine its response to treatment.METHODS: Index cases were children aged 6 to 18 years with habitual snoring and polysomnography (PSG)-confirmed OSA (obstructive apnea hypopnea index [OAHI] > 1 events/h). Each case was paired with an age-, sex-, and BMI-matched nonsnoring control subject recruited from our previous community growth survey. All subjects underwent FMD measurement in the morning aft er overnight PSG. Adenotonsillectomy (AT) was offered to subjects who satisfied predefined AT operation criteria. All cases underwent repeat PSG and FMD assessment 6 months later.RESULTS: A total of 63 case-control pairs were recruited. The OSA group had a significantly higher OAHI (median, 5.3 events/h [interquartile range (IQR), 2.6-11.7] vs 0.2 events/h [IQR, 0-0.5], P < .001) and lower FMD (mean +/- SD, 7.9% +/- 1.3% vs 8.3% +/- 0.8%; P = .04) than the control group. Thirty-two case subjects underwent AT. A significant reduction in OAHI was documented in the AT group (-8.8 events/h [IQR, -13.7 to -4.7]; P < .001) accompanied by a significant increase in FMD (+ 0.6% [IQR, 0.4-1.4]; P < .001), which was not observed in subjects who did not undergo AT.CONCLUSIONS: Children with OSA had reduced FMD, which was reversible with treatment.