软骨发育不全婴儿睡眠呼吸障碍的演变。

IF 2.1 4区 医学 Q3 CLINICAL NEUROLOGY
Janet M Legare, David G Ingram, Richard M Pauli, Jacqueline T Hecht, Lorena Dujmusic, David F Rodriguez-Buritica, Jeffrey W Campbell, Peggy Modaff, Mary E Little, Cory J Smid, Maria E Serna, Michael B Bober, Julie E Hoover-Fong, S Shahrukh Hashmi
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引用次数: 0

摘要

目的:软骨发育不全(ACH)患儿在婴儿期因睡眠呼吸障碍(SDB)和枕骨大孔狭窄(FMS)存在猝死风险。睡眠研究和神经成像在ACH婴儿中进行,但婴儿研究的解释具有挑战性。我们试图描述软骨发育不全婴儿的多导睡眠图(PSG)指数的基线数据,以及年龄和手术对这些参数的影响。方法:从2008-2017年CLARITY ACH多站点数据库中提取回顾性数据。提取阻塞性呼吸暂停低通气指数(OAHI)和中枢性呼吸暂停指数(CAI),分析年龄和手术干预(腺样体切除术[AD]或颈髓减压[CMD])对患者的影响。结果:分析了86例婴儿172例psg。在未接受手术的儿童中,OAHI在第一年下降,但在第二年上升,而CAI在前两年基本停滞不前。未接受手术的婴儿与接受过AD或CMD的婴儿的首次PSG年龄或PSG指数没有显著差异。AD后OAHI下降,CMD后CAI下降。结论:与平均身高的婴儿相似,我们的研究结果表明有必要在年龄背景下解释ACH儿童的睡眠研究结果,特别是对于阻塞性指数。OAHI和CAI都不能区分那些随后接受手术的婴儿,这表明在手术决策过程中还有其他重要的临床因素。与年龄无关,AD导致OSA和CMD的改善,并改善中枢性睡眠呼吸暂停。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evolution of sleep disordered breathing in infants with achondroplasia.

Purpose: Children with achondroplasia (ACH) are at risk for sudden death in infancy due to sleep disordered breathing (SDB) and foramen magnum stenosis (FMS). Sleep studies and neuroimaging are performed in infants with ACH, but interpretation of infant studies is challenging. We sought to describe baseline data on polysomnography (PSG) indices in infants with achondroplasia as well as effects of age and surgery on these parameters.

Methods: Retrospective data were abstracted from the multisite CLARITY ACH database from years 2008-2017. Both obstructive apnea hypopnea index (OAHI) and central apnea index (CAI) were extracted, and effects of age and surgical intervention (adenoidectomy [AD] or cervicomedullary decompression [CMD]) were analyzed.

Results: 172 PSGs from 86 infants were analyzed. In surgically naive children, OAHI decreased over the first year but then increased in the second year, while CAI was mostly stagnant over the first two years. There were no significant differences between age at first PSG or PSG indices for surgically naive infants versus those who underwent AD or CMD. OAHI decreased after AD and CAI decreased after CMD.

Conclusion: Similar to average stature infants, our results demonstrate the need to interpret sleep study findings of children with ACH in the context of age, particularly for obstructive indices. Neither OAHI nor CAI differentiated those infants who subsequently underwent surgery, suggesting that there were other important clinical factors in the surgical decision-making process. Independent of age, AD resulted in improvement in OSA and CMD with improvement in central sleep apnea.

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来源期刊
Sleep and Breathing
Sleep and Breathing 医学-呼吸系统
CiteScore
5.20
自引率
4.00%
发文量
222
审稿时长
3-8 weeks
期刊介绍: The journal Sleep and Breathing aims to reflect the state of the art in the international science and practice of sleep medicine. The journal is based on the recognition that management of sleep disorders requires a multi-disciplinary approach and diverse perspectives. The initial focus of Sleep and Breathing is on timely and original studies that collect, intervene, or otherwise inform all clinicians and scientists in medicine, dentistry and oral surgery, otolaryngology, and epidemiology on the management of the upper airway during sleep. Furthermore, Sleep and Breathing endeavors to bring readers cutting edge information about all evolving aspects of common sleep disorders or disruptions, such as insomnia and shift work. The journal includes not only patient studies, but also studies that emphasize the principles of physiology and pathophysiology or illustrate potentially novel approaches to diagnosis and treatment. In addition, the journal features articles that describe patient-oriented and cost-benefit health outcomes research. Thus, with peer review by an international Editorial Board and prompt English-language publication, Sleep and Breathing provides rapid dissemination of clinical and clinically related scientific information. But it also does more: it is dedicated to making the most important developments in sleep disordered breathing easily accessible to clinicians who are treating sleep apnea by presenting well-chosen, well-written, and highly organized information that is useful for patient care.
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