哮喘联盟

   摘要
   目的：研究哮喘与非哮喘儿童群体睡眠呼吸障碍（SDB）的发病率，评估行为问题是否与哮喘及SDB有关。
   研究设计：横断面研究2～15岁之间
   方法： 263名哮喘儿童及266名对照儿童(年龄2～15岁)进行常规儿科就诊时，其父母完成儿科睡眠问卷（PSQ）及儿童行为核检表。根据NIH指南对哮喘的严重程度进行分型。
   结果：哮喘儿童打鼾频率显著高于对照组（35.5% vs. 15.7%）,其PSQ阳性率也显著高于对照组（25.9% vs. 10.6%），两者的P值均< 0.001。哮喘的效应呈“剂量依赖”：随着哮喘严重程度的增加，打鼾和PSQ阳性率的优势比也增大。多变量分析显示，性别与哮喘以及年龄与性别之间存在显著的交互作用。校正后PSQ阳性、社会经济地位以及年龄是儿童行为核检表异常得分以及分型的独立预测因素。
   结论：哮喘儿童群体SDB的发病率显著高于非哮喘儿童，并且与哮喘严重程度呈正相关。多变量分析结果则显示哮喘的效应并不明确，其对PSQ阳性的预测作用仅表现在女孩中。SDB是儿童行为问题的独立预测因素，而哮喘不是。

 

（苏楠 审校）
Pediatr Pulmonol. 2014 Dec 2. doi: 10.1002/ppul.23120. [Epub ahead of print]


 

The prevalence of sleep-disordered breathing in children with asthma and its behavioral effects.
 

Goldstein NA1, Aronin C, Kantrowitz B, Hershcopf R, Fishkin S, Lee H, Weaver DE, Yip C, Liaw C, Saadia TA, Abramowitz J, Weedon J.
 

ABSTRACT
OBJECTIVES: To determine the prevalence of sleep-disordered breathing (SDB) in children with asthma compared to non-asthmatic children and to determine if behavior problems are associated with asthma and SDB.
STUDY DESIGN: Cross-Sectional.
METHODS: Parents of 263 children with asthma and 266 controls ages 2 to 15 years attending routine pediatric office visits completed the Pediatric Sleep Questionnaire (PSQ) and the Child Behavior Checklist. Asthma severity was classified based on NIH guidelines.
RESULTS: The prevalence of snoring was significantly higher in asthmatic children (35.5%) than controls (15.7%) and the prevalence of a positive PSQ was significantly higher in asthmatic children (25.9%) than controls (10.6%) (P < 0.001 for both). The effect of asthma was "dose-dependent" as children with more severe asthma had increased odds ratios for snoring and a positive PSQ. On multivariate analysis, there were significant interactions of gender with asthma and age with gender. A positive modified PSQ along with measures of socioeconomic status and age were the only independent predictors of abnormal Child Behavior Checklist scores and score classifications.
CONCLUSIONS: There was a higher prevalence of SDB in asthmatic children compared to non-asthmatic children and the prevalence of SDB increased with increasing asthma severity. In multivariate analysis the role of asthma was much less clear as it predicted a positive PSQ in girls but not boys. SDB, but not asthma, was an independent predictor of behavioral problems.
 

Pediatr Pulmonol. 2014 Dec 2. doi: 10.1002/ppul.23120. [Epub ahead of print]