目的 探讨学龄期哮喘患儿睡眠障碍的现状及其影响因素，为改善哮喘患儿的睡眠质量和生活质量提供科学依据。 方法 选取2022年3月—2024年3月南京医科大学附属儿童医院收治的学龄期哮喘患儿作为研究对象，使用调查问卷对其睡眠状况进行评估，根据评估结果分为睡眠障碍组（106例）和非睡眠障碍组（181例），采用多因素logistic回归分析探讨哮喘患儿睡眠障碍的影响因素。 结果 共纳入287例哮喘患儿，106例（36.9%）有睡眠障碍。多因素logistic回归分析显示，年龄>10岁、肥胖、服药依从性差、家庭功能不健康、被动吸烟、只参加部分体育活动均是学龄期哮喘患儿发生睡眠障碍的危险因素（P<0.05）。 结论 学龄期哮喘患儿睡眠障碍的发生率较高，且受多种因素影响，年龄、肥胖、服药依从性差、家庭功能不健康、有被动吸烟、只参加部分体育活动均是学龄期哮喘患儿发生睡眠障碍的危险因素，为改善哮喘患儿的睡眠质量和生活质量，应针对这些影响因素采取相应的干预措施。
Abstract
Objective To investigate the current status and influencing factors of sleep disorders in school-age children with asthma, providing a scientific basis for improving sleep quality and quality of life of asthmatic children. Methods This study selected school-age children with asthma admitted to the Children's Hospital of Nanjing Medical University from March 2022 to March 2024 as subjects. A questionnaire was used to assess their sleep conditions, and based on the assessment results, the participants were divided into a sleep disorder group (106 children) and a non-sleep disorder group (181 children). Multivariate logistic regression analysis was conducted to identify the influencing factors of sleep disorders in asthmatic children. Results A total of 287 asthmatic children were included, of which 106 (36.9%) had sleep disorders. Multivariate logistic regression analysis showed that being older than 10 years, obesity, poor medication adherence, unhealthy family functioning, passive smoking, and participation in only some physical activities were all risk factors for sleep disorders in school-aged children with asthma (P<0.05). Conclusions The incidence of sleep disorders in school-age children with asthma is relatively high and influenced by multiple factors, including age, obesity, poor medication adherence, unhealthy family functioning, passive smoking, and limited participation in physical activities. To improve the sleep quality and quality of life of asthmatic children, corresponding intervention measures should be implemented targeting these influencing factors.
关键词
哮喘 /
睡眠障碍 /
现状 /
影响因素 /
学龄期患儿
Key words
Asthma /
Sleep disorder /
Current status /
Influencing factor /
School-age child
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参考文献
1 丁玲, 肖玲, 陈成, 等. 患儿喘息、哮喘与睡眠呼吸障碍相关性Meta分析[J]. 中华临床免疫和变态反应杂志, 2021, 15(4): 398-404. DOI: 10.3969∕j.issn.1673-8705.2021.04.007.
2 Baddam SKR, Canapari CA, Van de Grift J, et al. Screening and evaluation of sleep disturbances and sleep disorders in children and adolescents[J]. Child Adolesc Psychiatr Clin N Am, 2021, 30(1): 65-84. PMID: 33223069. DOI: 10.1016/j.chc.2020.09.005.
3 慕超, 李进, 邢亮, 等. 铜川市3~6岁患儿睡眠障碍发生情况及影响因素调查分析[J]. 陕西医学杂志, 2021, 50(6): 759-762. DOI: 10.3969/j.issn.1000-7377.2021.06.030.
4 刘爱良, 郑跃杰, 杨琴, 等. 患儿支气管哮喘睡眠呼吸障碍特点分析[J]. 儿科药学杂志, 2022, 28(8): 32-35. DOI: 10.13407/j.cnki.jpp.1672-108X.2022.08.009.
5 中华医学会儿科学分会呼吸学组, 《中华儿科杂志》编辑委员会. 患儿支气管哮喘诊断与防治指南（2016年版）[J]. 中华儿科杂志, 2016, 54(3): 167-181. PMID: 26957061. DOI: 10.3760/cma.j.issn.0578-1310.2016.03.003.
6 Gaylor EE, Goodlin-Jones BL, Anders TF. Classification of young children's sleep problems: a pilot study[J]. J Am Acad Child Adolesc Psychiatry, 2001, 40(1): 61-67. PMID: 11195565. DOI: 10.1097/00004583-200101000-00017.
7 Paruthi S, Brooks LJ, D'Ambrosio C, et al. Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine[J]. J Clin Sleep Med, 2016, 12(6): 785-786. PMID: 27250809. PMCID: PMC4877308. DOI: 10.5664/jcsm.5866.
8 中华人民共和国国家质量监督检验检疫总局, 中国国家标准化管理委员会. 学生健康检查技术规范: GB/T 26343-2010[S]. 北京: 中国标准出版社, 2011.
9 钱铭怡, 武国城, 朱荣春, 等. 艾森克人格问卷简式量表中国版（EPQ-RSC）的修订[J]. 心理学报, 2000, 32(3): 317-323.
10 叶晓青, 林芳宇, 陈维清. 高血压病患者药物治疗依从性影响因素的研究[J]. 现代预防医学, 2007, 34(3): 494-496. DOI: 10.3969/j.issn.1003-8507.2007.03.036.
11 李真真, 李世懿, 于利萍, 等. 哮喘患儿睡眠障碍与家庭功能的现状调查及相关性分析[J]. 中国患儿保健杂志, 2023, 31(8): 846-850. DOI: 10.11852/zgetbjzz2022-1021.
12 朱亚敏, 杜莉, 王焕辉, 等. 阻塞性睡眠呼吸暂停低通气综合征合并重症哮喘的研究现状和挑战[J]. 中国全科医学, 2024, 27(25): 3192-3196. DOI: 10.12114/j.issn.1007-9572.2023.0759.
13 李沛隆, 连杰, 林娜, 等. 白细胞介素-33与患儿支气管哮喘的相关性研究进展[J]. 新乡医学院学报, 2021, 38(4): 374-377. DOI: 10.7683/xxyxyxb.2021.04.017.
14 周倩兰, 李淼. 哮喘患儿睡眠障碍的机制及研究进展[J]. 国际儿科学杂志, 2021, 48(10): 682-685. DOI: 10.3760/cma.j.issn.1673-4408.2021.10.007.
15 黄思艳, 秦岭, 刘海润, 等. 睡眠与患儿青少年语言发展[J]. 中华行为医学与脑科学杂志, 2021, 30(5): 476-480. DOI: 10.3760/cma.j.cn371468-20200930-01758.
16 Trosman I, Ivanenko A. Classification and epidemiology of sleep disorders in children and adolescents[J]. Child Adolesc Psychiatr Clin N Am, 2021, 30(1): 47-64. PMID: 33223068. DOI: 10.1016/j.chc.2020.08.002.
17 Reiter J, Ramagopal M, Gileles-Hillel A, et al. Sleep disorders in children with asthma[J]. Pediatr Pulmonol, 2022, 57(8): 1851-1859. PMID: 33647191. PMCID: PMC8408281. DOI: 10.1002/ppul.25264.
18 严双琴, 高国朋, 顾春丽, 等. 学龄前患儿哮喘与睡眠障碍对注意缺陷多动障碍症状发生的协同效应[J]. 中国公共卫生, 2021, 37(5): 824-828. DOI: 10.11847/zgggws1123008.
19 Bilgin N, Ozdogan S, Kaya A, et al. Sleep-related breathing disorders in children with asthma: impact on asthma control[J]. J Coll Physicians Surg Pak, 2022, 32(4): 473-477. PMID: 35330520. DOI: 10.29271/jcpsp.2022.04.473.
20 陈仪婷, 吕佳骏, 夏缘青, 等. 上海市3～12岁患儿睡眠状况[J]. 中国学校卫生, 2021, 42(6): 814-818. DOI: 10.16835/j.cnki.1000-9817.2021.06.004.
21 薛仁杰, 田曼. 患儿支气管哮喘合并睡眠障碍的研究进展[J]. 国际儿科学杂志, 2019, 46(12): 907-910. DOI: 10.3760/cma.j.issn.1673-4408.2019.12.012.
22 罗南, 王玲, 袁小平, 等. 中国哮喘患儿治疗依从性影响因素的Meta分析[J]. 儿科药学杂志, 2023, 29(12): 5-12. DOI: 10.13407/j.cnki.jpp.1672-108X.2023.012.002.
23 Trojanowska A, Emeryk A, Zarzycka D. Adherence to therapy regimen by children with asthma and their parents[J]. Postepy Dermatol Alergol, 2022, 39(2): 258-264. PMID: 35645686. PMCID: PMC9131973. DOI: 10.5114/ada.2022.115886.
24 温福华, 周焕南, 涂南萍, 等. 家庭功能与中小学生睡眠障碍及抑郁症状的关系[J]. 中国学校卫生, 2023, 44(5): 664-667. DOI: 10.16835/j.cnki.1000-9817.2023.05.006.
25 李昱剑, 王杨, 阚璇. 中国患儿哮喘急性发作危险因素的Meta分析[J]. 中国患儿保健杂志, 2021, 29(9): 992-995. DOI: 10.11852/zgetbjzz2020-1045.
基金
江苏省妇幼保健协会科研项目（FYX201905）。
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