唐氏综合征婴儿早期阻塞性睡眠呼吸暂停治疗的长期获益
Long-term benefits of early obstructive sleep apnea treatment in infants with Down syndrome.
文献信息
| PMID | 42986502 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Clotilde Mircher |
| 作者单位 | Institut Jérôme Lejeune, Rue Des Volontaires, 75015, Paris, France. clotilde.mircher@institutlejeune.org. |
| 期刊 | Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine |
| SCI 分区 | Q2 |
| IF | 4.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： Respire-21研究发现，与36月龄时接受标准照护的对照组（标准照护组）相比，从6至36月龄随访的唐氏综合征（DS）婴儿（筛查组）中，早期诊断和治疗阻塞性睡眠呼吸暂停（OSA）与神经认知和行为结局改善相关。本随访研究评估这些获益在60月龄时是否持续，以及早期OSA治疗是否影响语言和沟通结局。
方法： 来自初始研究的、被诊断并接受OSA治疗的儿童在60月龄时接受神经认知评估，使用Griffiths儿童发育量表第三版（Griffiths III）、Vineland适应行为量表第二版（VABS-II）以及实验室多导睡眠监测。
结果： 共纳入24名筛查组儿童和13名标准照护组儿童。Griffiths III发育总商数的组间差异倾向于筛查组，但无统计学显著性（3.9[标准误2.8]；p=0.130）。筛查组在Griffiths III学习基础领域（p=0.014）和个人-社会-情感领域（p=0.019），以及VABS-II总体综合评分（p=0.007）、日常生活技能领域（p=0.004）和社交化领域（p=0.005）得分显著更好。在语言或沟通结局方面未观察到显著获益。
结论： 在60月龄的DS婴儿中观察到早期OSA筛查和治疗的长期神经认知获益，尤其是在日常功能和社交化方面。
临床试验注册： 在ClinicalTrials.gov注册，注册号为NCT03210675（注册日期：2017-07-05）。
当前知识/研究依据： 阻塞性睡眠呼吸暂停（OSA）在唐氏综合征（DS）婴儿中非常常见。与不进行OSA系统评估相比，早期诊断和治疗OSA与36月龄时神经认知结局和行为显著改善相关。
研究影响： 本研究表明，与较晚接受诊断和治疗的儿童（即36月龄之后）相比，早期OSA干预具有持续获益（在60月龄时）。指南应调整以支持对确诊OSA进行早期干预。
英文摘要
PURPOSE: The Respire-21 study found that early obstructive sleep apnea (OSA) diagnosis and treatment is associated with improved neurocognitive and behavioral outcomes in infants with Down syndrome (DS) followed from 6 to 36 months of age (screened group) versus a control group receiving standard care at 36 months of age (standard care group). This follow-up study assessed whether these benefits persisted at 60 months of age and whether early OSA treatment influenced language and communication outcomes.
METHODS: Children from the initial study diagnosed with and treated for OSA underwent neurocognitive assessment at 60 months of age using the Griffiths Scales of Child Development, Third Edition (Griffiths III); the Vineland Adaptive Behavior Scales, Second Edition (VABS-II); and in-laboratory polysomnography.
RESULTS: Twenty-four screened group and 13 standard care group children were included. The between-group difference in Griffiths III Global Quotient of Development favored the screened group but was not statistically significant (3.9 [standard error 2.8]; p = 0.130). The screened group scored significantly better on the Griffiths III Foundations of Learning (p = 0.014) and Personal-Social-Emotional (p = 0.019) domains, and on the VABS-II global composite score (p = 0.007), Daily Living Skills (p = 0.004), and Socialization (p = 0.005) domains. No significant benefit was observed for language or communication outcomes.
CONCLUSION: Long-term neurocognitive benefits of early OSA screening and treatment were observed in infants with DS at 60 months of age, particularly for daily functioning and socialization.
CLINICAL TRIAL REGISTRATION: Registered at ClinicalTrials.gov under registration number NCT03210675 (registration date: 2017-07-05).
CURRENT KNOWLEDGE/STUDY RATIONALE: Obstructive sleep apnea (OSA) is very frequent in infants with Down syndrome (DS). Early diagnosis and treatment of OSA is associated with significant improvement of neurocognitive outcomes and behavior at 36 months of age compared to no systematic evaluation of OSA.
STUDY IMPACT: This study showed perduring benefits of early OSA interventions (at 60 months of age) compared with children receiving diagnosis and treatment later, i.e., after 36 months of age. Guidelines should be adapted to favor early interventions for OSA if diagnosed.