目的:探讨腺样体切除术治疗儿童分泌性中耳炎及鼾症的临床疗效。方法:对住院行腺样体切除术的120例分泌性中耳炎及鼾症患儿的临床表现、治疗方法和预后进行回顾性分析。结果:120例患儿经切除肥大的腺样体，辅以相应的药物治疗，临床症状均明显好转。结论:腺样体肥大较易成为儿童分泌性中耳炎及鼾症发病的基础因素。切除肥大的腺样体是治疗儿童分泌性中耳炎及鼾症有效、安全的方法。
Objective To study the prevalence of snoring in adults aged over 35 yrs in Kelamayi city of Xinjiang province, and screen the snoring associated factors.Methods 2600 subjects( age≥35 yrs) were enrolled from a random sample of the population living in 5 streets, two districts in Kelamayi city. All subjects were required to answer questions about their snoring by himself or bed partner at home. The questionnaire included items concerning snoring, daytime sleepness ( Epworth sleep scale, ESS) , smoking and drinking habits, while height, weight, neck circumference, abdominal circumference, waistline, and hip circumference were meatured. The subjects were assigned to a high risk group and a low risk group according to the questionaire of scoring. Results 2590 subjects had completed the questionnaire and 2513 ( 97. 0% )were eligble for evaluation. The cases of ever snoring was 1312 ( 52. 2% ) , among which moderate to severe snoring accounted for 38. 9% . Before the age of 60 yrs, the risk of snoring increased with age, and higher in males than females( 61. 7% vs. 45. 1% ) . The prevalence of snoring increased with neck circumference( P lt;0. 05) . The body mass index ( BMI) [ ( 28. 2 ±3. 6) kg/m2 vs. ( 25. 1 ±3. 9) kg/m2 ] , neck circumference [ ( 37. 7 ±3. 6) cmvs. ( 35. 6 ±3. 6) cm] , abdominal circumference [ ( 96. 9 ±13. 6) cm vs. ( 88. 7 ±11. 1) cm] , waistline [ ( 92. 2 ±9. 8) cm vs. ( 84. 7 ±10. 2) cm] , hip circumference [ ( 102. 9 ±9. 6) cm vs.( 96. 4 ±9. 3) cm] , proportionlity of waistline to hip circumference ( 0. 90 ±0. 07 vs. 0. 88 ±0. 08) , systolic blood pressure [ ( 132. 0 ±17. 5) mm Hg vs. ( 125. 6 ±16. 8) mm Hg] , and diastolic blood pressure [ ( 83. 3 ±12. 8) mm Hg vs. ( 78. 3 ±12. 6) mm Hg] were significantly different bettween the high and the low risk groups ( P lt; 0. 01) . Logistic regression analysis revealed that age ( OR = 1. 519) , BMI ( OR =2. 549) , neck circumference (OR = 2. 473) , smoking (OR = 2. 765) , ESS(OR = 2. 575) , and postmenopause( OR=1. 806) were main risk factors for snoring( P lt; 0. 05) . Conclusions The prevalence of snoring in adults over 35 yrs is high in Kelamayi city. The high risk factors for snoring are age, BMI, neck circumference, smoking, ESS, and post-menopause.
目的 阻塞性睡眠呼吸暂停低通气综合征（OSAHS）可引起心血管疾病发生增高，是高血压病及冠心病等的独立危险因素。打鼾是OSAHs的主要临床症状。本研究的主要目的是了解成都地区自然人群打鼾发生情况及其与心血管疾病危险因素的关系。 方法 2007年在成都市成华区采用随机抽样方法对男、女性共711人进行了心血管疾病危险因素调查[年龄45～80岁，平均（3.28 ± 6.25）岁，男性患者占所有患者的57.8%]，主要包括问卷调查、体格检查及血液学检查等，其中打鼾调查主要包括打鼾时间、次数及憋醒情况。将与打鼾相关的3个指标综合考虑后，计算出打鼾的严重程度，并分析了其与心血管疾病危险因素的关系。 结果 男性人群中打鼾率较女性高（62.0%、51.0%，P=0.003），且重度及极重度打鼾率也较女性高。随着打鼾的严重程度增加，体质量指数、血肌酐及尿酸等心血管疾病危险因素逐渐升高（趋势P均＜0.05），而高密度脂蛋白胆固醇逐渐降低（P=0.001）。另外，随着打鼾的严重程度增加，高血压患病率及收缩压也逐渐升高，但无统计学意义（趋势P=0.063，0.08）。 结论 成都地区中老年城镇人群的打鼾率较高，且男性高于女性。另外，随着打鼾的严重程度增加，心血管疾病危险因素也逐渐升高。这提示我们在临床工作中，对于打鼾的患者需要加强心血管疾病危险因素的筛查及干预，以期减少它的发生发展。
Habitual snoring can occur in both children and adults. If it is physiological snoring, it usually does not require special intervention. If it is pathological snoring, such as snoring caused by central diseases and obstructive diseases, it needs to be treated as soon as possible. Habitual snoring has more harm to children, such as causing sleep structure disorders, slow growth and development. During the snoring process, children’s sleep fragmentation and hypoxia state lead to changes in the transmission of neurochemicals in the brain’s precortex, causing adverse effects on brain function and inducing attention deficit hyperactivity disorder. This article reviews relevant research in recent years to further elucidate the relationship between children’s habitual snoring and attention deficit hyperactivity disorder, and provide a basis for future clinical research and intervention.
ObjectiveTo investigate the causal relationship between gastroesophageal reflux disease (GERD) and obstructive sleep apnea (OSA) with its typical symptoms (snoring and daytime sleepiness) by using Mendelian randomization (MR). MethodsThe inverse-variance weighted method was used as the main analysis method to assess the causal effect. Sensitivity and pleiotropy analyses were carried out using leave-one-out and MR-Egger analysis, and then heterogeneity tests were conducted. ResultsIn the MR analysis, genetically predicted GERD was associated with a greater risk of OSA (IVW: OR=1.528, 95%CI 1.374 to 1.699, P=5.315E‒15). Additional MR results were consistent with the IVW results, and no pleiotropy or heterogeneity was found. We also discovered a significant causal relationship between GRED and snoring (IVW: OR=0.959, 95%CI 0.949 to 0.969, P=1.507E‒15), and daytime sleepiness (IVW: OR=1.024, 95%CI 1.021 to 1.036, P=4.580E‒5), with no evidence of pleiotropy. ConclusionThe MR study supports a causal effect between GERD and OSA with its typical symptoms (daytime sleepiness and snoring).