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目的通过对比合并与不合并注意缺陷多动障碍(ADHD)的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)儿童的多导睡眠监测指标,试图从睡眠结构和睡眠主要参数的层次上来探讨ADHD的发病机制。方法选择2004-01—2006-10于广州市儿童医院就诊的OSAHS患儿36例作为OSAHS组,合并有OSAHS的ADHD患儿20例作为观察组,选取无OSAHS及ADHD的儿童30例作为对照组,三组之间在年龄、性别、体重指数等方面相比,差异无显著性。通过多导睡眠监测(PSG),并由神经康复科专科医生对其是否患有ADHD作出诊断。采用相应的统计学方法,对OSAHS组、观察组及对照组的睡眠结构进行比较,并对OSAHS组和观察组进行呼吸事件及血氧状况的比较。结果(1)与对照组相比,OSAHS组及观察组睡眠Ⅰ期增加,睡眠Ⅱ期、SWS及REM睡眠减少,差异有统计学意义(P<0.05),OSAHS组的REM%为8.66±3.94,观察组的REM%为5.65±5.41,REM%的改变有统计学意义(P<0.05)。(2)观察组儿童呼吸事件的次数与持续时间及血氧饱和度下降较OSAHS儿童严重,差异有统计学意义(P<0.05)。结论观察组儿童REM%及血氧饱和度的下降可能在ADHD的发病中起一定的作用。
OBJECTIVE: To compare the polysomnography markers in children with obstructive sleep apnea-hypopnea syndrome (OSAHS) with and without ADHD, and to explore the relationship between ADHD and sleep-onset parameters Pathogenesis. Methods A total of 36 children with OSAHS admitted to Guangzhou Children’s Hospital from January 2004 to June 2006 were selected as the OSAHS group. Twenty children with ADHD complicated with OSAHS were selected as the observation group. Thirty children without OSAHS and ADHD were selected as the control group There was no significant difference between the three groups in terms of age, sex and body mass index. Through polysomnography (PSG) and diagnosed by neuro-rehabilitation specialist as to whether they have ADHD or not. The corresponding statistical methods were used to compare the sleep structures of OSAHS group, observation group and control group, and to compare respiratory events and blood oxygenation between OSAHS group and observation group. Results Compared with the control group, OSAHS group and observation group increased stage I sleep, stage II sleep, SWS and REM sleep decreased, the difference was statistically significant (P <0.05), OSAHS group REM% was 8.66 ± 3.94 , The REM% of the observation group was 5.65 ± 5.41, the change of REM% was statistically significant (P <0.05). (2) The number and duration of respiratory events in children in observation group and the decline of oxygen saturation were more serious than those in children with OSAHS (P <0.05). Conclusions The decrease of REM% and oxygen saturation in the observation group may play a role in the pathogenesis of ADHD.