论文部分内容阅读
目的探讨儿童阻塞性睡眠呼吸暂停综合征(OSAHS)对患儿左心室收缩、舒张功能的影响。方法对2006年12月至2008年2月因打鼾或睡眠呼吸异常来新疆医科大学第一附属医院儿科就诊的51例患儿,实施多导睡眠监测仪(polysomnography,PSG)检测,以其检测结果将患儿分为OSAHS组(29例)和原发性鼾症(PS)组(22例)。分别对两组患儿进行多普勒超声心动图检测,主要指标包括:左室短轴缩短率(LVFS)、左室射血分数(LVEF)、每搏输出量(LVSV)、舒张早期峰值血流速度(MVE)、舒张晚期峰值血流速度(MVA)、MVE/A比值等有关指标,分析比较这些参数的变化以及与OSAHS的关系。结果OSAHS组与PS组患儿的比较显示:(1)OS-AHS组患儿的呼吸紊乱指数(AHI)(13.2±9.2对1.2±1.1)结果高于PS患儿(P<0.05),最低血氧饱和度(LSaO2)(78.5±5.4对87.4±3.7)低于PS患儿(P<0.05);(2)OSAHS组患儿MVA(0.62±0.1对0.57±0.1)高于PS组患儿(P<0.05),OSAHS组患儿E/A比值(1.58±0.24对1.73±0.25)低于PS组患儿(P<0.05);(3)OSAHS组患儿ME/A值和LSaO2(R=-0.527,P<0.05)呈负相关。结论OSAHS能影响儿童左心室舒张功能,而未发现对收缩功能有影响。另外多普勒超声心动图不仅是OSAHS患儿心功能最重要的无创监测方法之一,还可提供患儿左室重塑,收缩和舒张功能是否受损的指标,对临床判断OSAHS病情程度及预后有重要价值。
Objective To investigate the effect of obstructive sleep apnea syndrome (OSAHS) on left ventricular systolic and diastolic function in children. Methods From December 2006 to February 2008, 51 children admitted to the pediatric department of the First Affiliated Hospital of Xinjiang Medical University for snoring or sleep apnea were examined with polysomnography (PSG) The children were divided into OSAHS group (n = 29) and primary snoring group (n = 22). Doppler echocardiography was performed on two groups of children respectively. The main indexes included left ventricular fractional shortening (LVFS), left ventricular ejection fraction (LVEF), stroke volume (LVSV), early diastolic peak blood MVE, MVA and MVE / A ratios were analyzed to compare the changes of these parameters and the relationship with OSAHS. Results Comparisons between OSAHS group and PS group showed that: (1) The respiratory disturbance index (AHI) in OS-AHS group (13.2 ± 9.2 vs. 1.2 ± 1.1) was higher than that in PS group (P <0.05) (2) The MVA in OSAHS group (0.62 ± 0.1 vs. 0.57 ± 0.1) were significantly higher than those in PS group (78.5 ± 5.4 vs 87.4 ± 3.7, P <0.05) (P <0.05). The E / A ratio in OSAHS group (1.58 ± 0.24 vs. 1.73 ± 0.25) was lower than that in PS group (P <0.05). (3) The ME / A ratio and LSaO2 = -0.527, P <0.05) was negatively correlated. Conclusion OSAHS can affect left ventricular diastolic function in children without any effect on systolic function. In addition Doppler echocardiography is not only one of the most important noninvasive methods of cardiac function in children with OSAHS, but also provide indicators of left ventricular remodeling, systolic and diastolic function in children with impaired, the clinical judgment of OSAHS severity and Prognosis has important value.