睡眠呼吸障礙對兒童身高、體重和認(rèn)知功能的影響
發(fā)布時(shí)間：2019-05-19 16:41
【摘要】：目的通過對比分析學(xué)齡前期和學(xué)齡期兒童的生長發(fā)育指標(biāo)、認(rèn)知測試得分,以期找到睡眠呼吸障礙(SDB)對不同年齡段兒童身高、體重及認(rèn)知功能影響的客觀證據(jù),探討其發(fā)病機(jī)制,為改善患兒生存及生活質(zhì)量的最佳干預(yù)方式提供依據(jù)。 方法從2009年11月～2011年2月因夜間睡眠打鼾、張口呼吸伴或不伴憋氣,在寧夏醫(yī)科大學(xué)附屬醫(yī)院耳鼻咽喉頭頸外科住院治療并進(jìn)行多導(dǎo)睡眠監(jiān)測的兒童中,隨機(jī)抽取129例,其中男94例,女35例,年齡4～12歲。將129例研究對象進(jìn)行兩次不同的分組:①根據(jù)不同年齡段的患兒認(rèn)知測試使用的量表不同,將129例研究對象分為學(xué)齡前期組和學(xué)齡期組;符合學(xué)齡前期組的患兒68例,學(xué)齡期組的患兒61例;②根據(jù)兒童阻塞性睡眠呼吸暫停低通氣綜合征(OSAHS)、原發(fā)性打鼾(PS)的診斷標(biāo)準(zhǔn),分別將學(xué)齡前期組和學(xué)齡期組的兒童分為OSAHS組和PS組。分期對比分析OSAHS組和PS組的身高、體重、體質(zhì)量指數(shù)(BMI)。從當(dāng)?shù)赜變簣@、小學(xué)中隨機(jī)選取同期無睡眠打鼾、張口呼吸、憋氣等癥狀并符合本研究排除標(biāo)準(zhǔn)的健康兒童60例為對照組,其中學(xué)齡前期和學(xué)齡期各30例,其年齡、性別、身高、體重及其來源均與研究組相似。應(yīng)用中國韋氏幼兒及兒童智力量表及劃銷測驗(yàn),記錄OSAHS組和PS組的測試結(jié)果,并與同期的正常兒童作對照;應(yīng)用SPSS16.0統(tǒng)計(jì)軟件包進(jìn)行統(tǒng)計(jì)分析。 結(jié)果⑴身高、體重①學(xué)齡前期OSAHS組、PS組在年齡構(gòu)成、男女比例上差異無統(tǒng)計(jì)學(xué)意義(P0.05),兩組的體重相比無顯著性差異(P0.05);OSAHS組的身高低于PS組、BMI高于PS組,均有顯著性差異(P0.01)。②學(xué)齡期OSAHS組、PS組在年齡構(gòu)成、男女比例上差異無統(tǒng)計(jì)學(xué)意義(P0.05),兩組的身高相比無顯著性差異(P0.05);OSAHS組的體重、BMI高于PS組,有顯著差異(P0.01)。⑵學(xué)齡前期和學(xué)齡期OSAHS組和PS組的慢波睡眠期(SWS)和快速動(dòng)眼睡眠期(REM)占睡眠時(shí)間百分比無顯著差異(P0.05);OSAHS組阻塞性呼吸暫停指數(shù)(OAI)、呼吸暫停低通氣指數(shù)(AHI)均明顯高于PS組(P0.01),最低血氧飽和度(SaO2)明顯低于PS組(P0.01)。⑶認(rèn)知功能①學(xué)齡前期OSAHS組、PS組、正常對照組三組之間言語智商(VIQ)、操作智商(PIQ)、總智商(FIQ)測定結(jié)果比較,OSAHS組VIQ、FIQ均明顯低于對照組及PS組,差異有統(tǒng)計(jì)學(xué)意義(P0.01);PS組的VIQ、PIQ、FIQ與對照組相比,差異無統(tǒng)計(jì)學(xué)意義(P0.05);在智力測驗(yàn)各分測驗(yàn)比較中,OSAHS組與PS組相比在言語量表的四個(gè)分測驗(yàn)知識(shí)、算術(shù)、圖片概括、領(lǐng)悟及操作量表分測驗(yàn)動(dòng)物下蛋的得分較低(P0.05),其他分測驗(yàn)無顯著性差異(P0.05);OSAHS組與對照組相比,除幾何圖形這一分測驗(yàn)的得分無顯著性差異,余十項(xiàng)測試均低于對照組(P0.05);PS組與對照組相比,在算術(shù)、動(dòng)物下蛋、圖畫填充、迷津的得分較低,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。②學(xué)齡期OSAHS組PIQ、FIQ均低于對照組及PS組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);PS組VIQ、PIQ、FIQ與對照組相比,無統(tǒng)計(jì)學(xué)差異(P0.05);在各分測驗(yàn)中,OSAHS組與PS組相比在操作量表的分測驗(yàn)圖片排列、木塊圖案、編碼的得分較低,差異有統(tǒng)計(jì)學(xué)意義(P0.01),在其他分測驗(yàn)中無顯著性差異(P0.05);OSAHS組與對照組相比,除數(shù)字廣度這一分測驗(yàn)的得分無顯著性差異,余十項(xiàng)分測驗(yàn)均低于對照組(P0.05);PS組與對照組相比,在分類、詞匯、領(lǐng)悟、圖片排列上差異有統(tǒng)計(jì)學(xué)意義(P0.05)。③三組間注意力測試結(jié)果的比較OSAHS組的失誤率高于PS組(P0.05);和對照組相比,OSAHS組、PS組失誤率均明顯增高(P0.01)。 結(jié)論⑴兒童OSAHS對學(xué)齡前兒童的身高、學(xué)齡兒童的體重有明顯影響,SDB可影響兒童的生長發(fā)育;⑵學(xué)齡前期與學(xué)齡期OSAHS組與PS組的睡眠結(jié)構(gòu)無明顯差異;⑶學(xué)齡前期和學(xué)齡期SDB兒童均已出現(xiàn)多種認(rèn)知功能方面的缺陷,SDB可導(dǎo)致認(rèn)知功能的損害、影響兒童智力發(fā)育,應(yīng)盡早采取干預(yù)措施以保障兒童健康成長。
[Abstract]:Objective To study the effect of sleep disordered breathing (SDB) on the height, weight and cognitive function of children in different age groups by comparing the growth and development indexes and the cognitive test scores of the children in the pre-school and the early stage. And provides the basis for improving the survival and quality of life of the child. Methods 129 cases were randomly selected from November,2009 to February,2011 for nocturnal sleep snoring, open-mouth breathing with or without breathing, and 129 cases were randomly selected in the children with otorhinolaryngology and head-neck surgery in the Affiliated Hospital of Ningxia Medical University, including 94 males and 35 females. Example, Age 4-12 A total of 129 subjects were divided into two different groups:1. According to the scales used in the cognitive test of the children of different age groups,129 subjects were divided into the pre-school group and the pre-school group;68 of the children who met the pre-school group and 61 of the children with the same age group Example: Children were divided into OSAHS group and PS group respectively according to the diagnosis criteria of children's obstructive sleep apnea-hypopnea syndrome (OSAHS) and primary snoring (PS). The height, body weight, body mass index (BMI) of the OSAHS group and the PS group were analyzed by stages. ).60 healthy children were randomly selected from the local kindergartens and primary schools for the same period without sleep snoring, open-mouth breathing, and breath-holding, and were in accordance with the exclusion criteria of the study. High, body weight and its source are in phase with the study group The test results of the OSAHS group and the PS group were recorded and compared with the normal children in the same period. The SPSS16.0 statistical software package was used for statistical analysis. The results showed that there was no significant difference between the two groups (P0.05). The difference between the two groups was not significant (P0.05). The height of the OSAHS group was lower than that of the PS group, and the BMI was higher than that of the PS group (P <0.05). There was no significant difference between the two groups (P0.05). The body weight and BMI of the OSAHS group were higher than that of the PS group (P0.05). (01) The slow-wave sleep period (SWS) and fast-moving-eye sleep (REM) of the OSAHS group and the PS group in the first and the second stage were significantly higher than those in the PS group (P0.05); the obstructive sleep apnea index (OAI) and the apnea-hypopnea index (AHI) in the OSAHS group were significantly higher than those in the PS group (P0. 01) The minimum oxygen saturation (SaO2) was significantly lower than that of the PS group (P0. Results Compared with the control group and the PS group, the VIQ and FIQ of the OSAHS group were significantly lower than that in the control group and the PS group (P0.01). The VIQ of the PS group was significantly lower than that of the control group and the PS group. Compared with the control group, the difference of PIQ and FIQ was not significant (P0.05); in the comparison of the subtest of the intelligence test, the scores of the four sub-test knowledge, arithmetic, picture summarization, comprehension and operation scale of the OSAHS group and the PS group in the speech scale were lower (P0. (05) There was no significant difference in other subtests (P0.05). There was no significant difference in the score of the subtest in the OSAHS group and the control group, and the remaining ten tests were lower than that of the control group (P0.05). Compared with the control group, the scores of the remaining ten tests were lower than that of the control group (P0.05); the PS group and the control group were in arithmetic, the eggs in the animals, the pictures were filled, and the maze was obtained. The difference was lower and the difference was significant (P0. Results The PIQ and FIQ of the OSAHS group were lower than that in the control group and the PS group (P <0.05). Compared with the control group, there was no statistical difference (P <0.05). In each subtest, the scores of the OSAHS group and the PS group were compared with the control group, and there was no statistical difference (P0.05); in each subtest, the OSAHS group and the PS group were arranged in the sub-test pictures of the operation scale, and the wood The scores of the block pattern and the coding were lower, the difference was significant (P0.01), and there was no significant difference in the other subtests (P0.05); the scores of the OSAHS group and the control group did not differ significantly, and the remaining ten subscores were lower than that of the control group (P0. (05) Compared with the control group, the difference of the group, the vocabulary, the comprehension and the picture arrangement was statistically significant (P0. Compared with the control group, the error rate of OSAHS group was higher than that in PS group (P0.05). Conclusion The OSAHS of preschool children has a significant effect on the height of preschool children and the weight of school-age children, and SDB can affect the growth and development of children. There is no obvious difference; in the pre-school and in the early stage, SDB children have various cognitive functions, SDB can lead to the impairment of cognitive function and affect the intelligence development of children, and the intervention measures should be taken as early as possible to guarantee the children
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R766
本文編號(hào)：2480883
[Abstract]:Objective To study the effect of sleep disordered breathing (SDB) on the height, weight and cognitive function of children in different age groups by comparing the growth and development indexes and the cognitive test scores of the children in the pre-school and the early stage. And provides the basis for improving the survival and quality of life of the child. Methods 129 cases were randomly selected from November,2009 to February,2011 for nocturnal sleep snoring, open-mouth breathing with or without breathing, and 129 cases were randomly selected in the children with otorhinolaryngology and head-neck surgery in the Affiliated Hospital of Ningxia Medical University, including 94 males and 35 females. Example, Age 4-12 A total of 129 subjects were divided into two different groups:1. According to the scales used in the cognitive test of the children of different age groups,129 subjects were divided into the pre-school group and the pre-school group;68 of the children who met the pre-school group and 61 of the children with the same age group Example: Children were divided into OSAHS group and PS group respectively according to the diagnosis criteria of children's obstructive sleep apnea-hypopnea syndrome (OSAHS) and primary snoring (PS). The height, body weight, body mass index (BMI) of the OSAHS group and the PS group were analyzed by stages. ).60 healthy children were randomly selected from the local kindergartens and primary schools for the same period without sleep snoring, open-mouth breathing, and breath-holding, and were in accordance with the exclusion criteria of the study. High, body weight and its source are in phase with the study group The test results of the OSAHS group and the PS group were recorded and compared with the normal children in the same period. The SPSS16.0 statistical software package was used for statistical analysis. The results showed that there was no significant difference between the two groups (P0.05). The difference between the two groups was not significant (P0.05). The height of the OSAHS group was lower than that of the PS group, and the BMI was higher than that of the PS group (P <0.05). There was no significant difference between the two groups (P0.05). The body weight and BMI of the OSAHS group were higher than that of the PS group (P0.05). (01) The slow-wave sleep period (SWS) and fast-moving-eye sleep (REM) of the OSAHS group and the PS group in the first and the second stage were significantly higher than those in the PS group (P0.05); the obstructive sleep apnea index (OAI) and the apnea-hypopnea index (AHI) in the OSAHS group were significantly higher than those in the PS group (P0. 01) The minimum oxygen saturation (SaO2) was significantly lower than that of the PS group (P0. Results Compared with the control group and the PS group, the VIQ and FIQ of the OSAHS group were significantly lower than that in the control group and the PS group (P0.01). The VIQ of the PS group was significantly lower than that of the control group and the PS group. Compared with the control group, the difference of PIQ and FIQ was not significant (P0.05); in the comparison of the subtest of the intelligence test, the scores of the four sub-test knowledge, arithmetic, picture summarization, comprehension and operation scale of the OSAHS group and the PS group in the speech scale were lower (P0. (05) There was no significant difference in other subtests (P0.05). There was no significant difference in the score of the subtest in the OSAHS group and the control group, and the remaining ten tests were lower than that of the control group (P0.05). Compared with the control group, the scores of the remaining ten tests were lower than that of the control group (P0.05); the PS group and the control group were in arithmetic, the eggs in the animals, the pictures were filled, and the maze was obtained. The difference was lower and the difference was significant (P0. Results The PIQ and FIQ of the OSAHS group were lower than that in the control group and the PS group (P <0.05). Compared with the control group, there was no statistical difference (P <0.05). In each subtest, the scores of the OSAHS group and the PS group were compared with the control group, and there was no statistical difference (P0.05); in each subtest, the OSAHS group and the PS group were arranged in the sub-test pictures of the operation scale, and the wood The scores of the block pattern and the coding were lower, the difference was significant (P0.01), and there was no significant difference in the other subtests (P0.05); the scores of the OSAHS group and the control group did not differ significantly, and the remaining ten subscores were lower than that of the control group (P0. (05) Compared with the control group, the difference of the group, the vocabulary, the comprehension and the picture arrangement was statistically significant (P0. Compared with the control group, the error rate of OSAHS group was higher than that in PS group (P0.05). Conclusion The OSAHS of preschool children has a significant effect on the height of preschool children and the weight of school-age children, and SDB can affect the growth and development of children. There is no obvious difference; in the pre-school and in the early stage, SDB children have various cognitive functions, SDB can lead to the impairment of cognitive function and affect the intelligence development of children, and the intervention measures should be taken as early as possible to guarantee the children
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類號(hào)】：R766
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