Natural history and predictors for progression of mild childhood obstructive sleep apnoea
Natural history and predictors for progression of mild childhood obstructive sleep apnoea
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DOI：
10.1136/thx.2009.120220
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发表时间：
2010-01-01
期刊：
影响因子：
10
通讯作者：
Wing, Y. K.
中科院分区：
文献类型：
--
作者：
Li, A. M.;Au, C. T.;Wing, Y. K.
目的：研究儿童轻度阻塞性睡眠呼吸暂停(OSA)的自然病史，并找出与疾病进展相关的因素。方法：从流行病学研究中招募受试者，调查6-13岁儿童OSA的患病率。结果：45名儿童参与了随访研究，其中13名(29%)OSA恶化。与OSA没有恶化的患者相比，OSA恶化组的腰围增加更多，在基线和随访时大扁桃体(占呼吸道的50%)的患病率更高，在基线和随访时习惯性打鼾率更高。大扁桃体的存在对两年内OSA的恶化有53%的阳性预测值和83%的阴性预测值。多因素线性回归分析显示，阻塞性呼吸暂停低通气指数的改变与基线年龄(β(SE)=0.92(0.34)，p=0.009)、性别(男1；女=0)(β(SE)=4.69(1.29)，p=0.05)有关。
Aims: The natural history of mild childhood obstructive sleep apnoea (OSA) was examined and factors associated with disease progression were identified.Methods: Subjects were recruited from an epidemiological study which examined the prevalence of OSA in Chinese children aged 6-13 years. The first 56 consecutive children identified with mild OSA (apnoea-hypopnoea index 1-5) were invited for a repeat assessment 2 years after the diagnosis.Results: 45 children participated in the follow-up study, in 13 of whom (29%) the OSA was found to have worsened. Compared with those in whom OSA had not worsened, the worsened OSA group had a greater increase in waist circumference, a higher prevalence of large tonsils (occupying >50% of the airway) at both baseline and follow-up, and a higher prevalence of habitual snoring at both baseline and follow-up. The presence of large tonsils had a positive predictive value of 53% and a negative predictive value of 83% for worsening OSA over a 2-year period. Multivariate linear regression analysis showed that the change in obstructive apnoea-hypopnoea index was associated with age at baseline (beta (SE) = 0.92 (0.34), p = 0.009), gender (male = 1; female = 0) (beta (SE) = 4.69 (1.29), p