Objectives To evaluate the autonomic nervous system function in children with obstructive sleep apnea syndrome (OSAS) by heart rate variability (HRV) analysis. Methods A total of 93 snoring children (≥5 years old) were enrolled. All subjects underwent polysonmography and spectrum analysis of heart rate variability using 24-hour Holter electrocardiograms. Time domain indices, SDNN, RMSSD, SDANN, and PNN50, and frequency domain indices, low fire-qnency (LF) and high frequency (HF), as well as LF/HF were included in HRY analysis. Results Forty-ssven of 93 children met the criteria for OSAS and 46 did not. HRV analysis showed that OSAS children had significantly decreased SDNN and SDANN than those of non-GSAS children (all P＜0.01). Nocturnal PNN50 in OSAS children was significanlty decreased while LF/HF was significantly elevated compared to those of non-OSAS children (P=0.025 and 0,026 respectively). Multiple regression analysis showed that SDNN was significantly related to apnea-hypopnea index and age (P=0.03 and 0.006, re-spectively). Conclusions Autooomic nervous system dysfunctions are found in OSAS children with sympathetic overflow* weaker parasympathetic modulation and dysfunction of equilibrium between sympathetic and parasympathetie nerves as main manifestations.%目的 分析心率变异性 (HRV) 评估阻塞性睡眠呼吸暂停综合征 (OSAS) 儿童的自主神经功能.方法 对93名≥5岁的打鼾儿童,在睡眠监测同时进行24 h动态心电图监测.HRV分析包括时域指标和频域指标,即SDNN、RMSSD、SDANN、PNN50、低频功率谱 (LF)、高频功率谱 (HF) 以及LF/HF.结果 93名儿童中,47名儿童符合OSAS诊断,46名为非OSAS.OSAS组的SDNN、SDANN较非OSAS组降低,差异有统计学意义 (P 均<0.01);不同严重程度OSAS患儿间,其SDNN的差异也有统计学意义 (P <0.01).OSAS组较非OSAS组夜间PNN50降低,LF/HF增高,差异均有统计学意义 (P =0.025,0.026).多元逐步回归分析显示,SDNN与阻塞性呼吸暂停指数 (AHI) 和年龄显著相关 (P =0.03,0.006).结论 OSAS儿童已经出现自主神经功能损害,主要表现为夜间交感神经兴奋性增高、副交感神经兴奋性减弱以及交感/副交感神经平衡功能失调.
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