PDF(Pubmed)
Abstract：
This review investigates the relationship between pediatric obstructive sleep apnea, often associated with adenotonsillar hypertrophy, and cardiovascular health, particularly pulmonary hypertension. We conducted a comprehensive literature search using electronic databases, including Medline Pub-Med, Scopus, and the Web of Science. The study analyzed a total of 230 articles and screened 48 articles, with 20 included in the final analysis, involving 2429 children. The PRISMA flowchart visually illustrates the selection process, and the ROBINS-E and -I tools help ensure the reliability and validity of the evidence produced by these studies. These studies explored various aspects, including the severity of obstructive sleep apnea, cardiac anomalies, cardiac stress markers, risk factors for pulmonary hypertension, and the impact of adenoidectomy and tonsillectomy on cardiac function. The research found that adenotonsillar hypertrophy and obstructive sleep apnea are significant risk factors for cardiovascular complications, especially pulmonary hypertension, in children. Adenoidectomy and tonsillectomy may provide effective treatments. Following adenoidectomy in relation to obstructive sleep apnea, there appears to be a reduction in mean pulmonary artery pressure during echocardiographic examination. However, the efficacy of these procedures can vary based on the severity of obstructive sleep apnea and individual cardiac conditions. The study also identified concerns regarding data bias. The authors emphasize the need for well-designed clinical studies, including both healthy patients with adenotonsillar hypertrophy and vulnerable children with genetic disorders, to ensure that clinical decisions are based on solid scientific evidence.
摘要：
本文综述了小儿阻塞性睡眠呼吸暂停之间的关系，常伴有腺体扁桃体肥大，和心血管健康，尤其是肺动脉高压。我们使用电子数据库进行了全面的文献检索，包括MedlinePub-Med,Scopus,和WebofScience.该研究共分析了230篇文章，筛选了48篇文章，最终分析包括20个，涉及2429名儿童。PRISMA流程图直观地说明了选择过程，和ROBINS-E和-I工具有助于确保这些研究产生的证据的可靠性和有效性。这些研究探讨了各个方面，包括阻塞性睡眠呼吸暂停的严重程度，心脏异常,心脏压力标志物,肺动脉高压的危险因素，以及腺样体切除和扁桃体切除对心功能的影响。研究发现腺样体扁桃体肥大和阻塞性睡眠呼吸暂停是心血管并发症的显著危险因素,尤其是肺动脉高压,在儿童。腺样体切除术和扁桃体切除术可以提供有效的治疗。腺样体切除术后与阻塞性睡眠呼吸暂停有关，在超声心动图检查期间,平均肺动脉压似乎有所降低.然而,这些手术的疗效可能因阻塞性睡眠呼吸暂停的严重程度和个体心脏状况而异.该研究还确定了有关数据偏差的担忧。作者强调需要精心设计的临床研究，包括患有腺样体扁桃体肥大的健康患者和患有遗传性疾病的脆弱儿童，确保临床决策基于可靠的科学证据。
