儿童OSAHS危险因素和微觉醒预警机制探讨

doi:10.3969/j.issn.2095-9400.2015.03.006

科研成果详情

题名	儿童OSAHS危险因素和微觉醒预警机制探讨
其他题名	Mechanism of risk factors alert and systematic inlfammation response in children with obstructive sleep apnea and hypopnea syndrome
作者	苏苗赏1; 俞晨艺 1; 张渊博 2; 周洋洋2; 徐莉2; 蔡晓红1
发表日期	2015-03-25
发表期刊	温州医科大学学报影响因子和分区
语种	中文
原始文献类型	学术期刊
关键词	阻塞性睡眠呼吸暂停低通气综合征多导睡眠监测微觉醒炎症危险因素儿童
其他关键词	obstructive sleep apnea and hypopnea syndrome ; polysommongraphy ; arousal ; inlfammation ; risk factors ; children
摘要	目的:调查儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的危险因素,探讨脑电微觉醒与全身炎症反应的相关性。方法:对2013年1月至2014年6月我院儿童呼吸科门诊收治的285例6~11岁鼾症儿童进行睡眠问卷调查和整夜多导睡眠监测(PSG),比较OSAHS患儿和非OSAHS患儿的临床资料,分析OSAHS的相关危险因素。随机选取30例鼾症儿童进行血炎症指标检测,分析睡眠效率(SE)、睡眠结构、微觉醒指数(AI)、氧减指数及各种睡眠呼吸紊乱指数等睡眠参数以及血常规、C反应蛋白(CRP)、白介素-1β(IL-1β)的表达水平。结果:56例(占19.6%)患儿被诊断为OSAHS。与非OSAHS组比较,OSAHS患儿与多种睡眠相关症状显著相关。Logistic回归分析显示,OSAHS主要危险因素有扁桃体腺样体肥大、习惯性打鼾(>3次/周)、肥胖、张口呼吸、夜间遗尿、白天过度活跃和脾气暴躁。睡眠参数分析显示,OSAHS患儿睡眠总时间(TST)、SE、深睡眠(II期+IV期睡眠)和快速眼动(REM)期睡眠时间减少,浅睡眠(I期+I期睡眠)时间增多,AI增高;最低氧饱和度(LSa O2)、阻塞性呼吸暂停指数(OAI)、呼吸暂停低通气指数(AHI)和呼吸紊乱指数(RDI)在OSAHS和非OSAHS儿童间差异均有统计学意义。OSAHS患儿血白细胞计数、血CRP及IL-1β表达水平均明显增高。Pearson相关分析显示,OSAHS患儿AI与RDI呈正相关(r=7.56,P<0.01),与血IL-1β表达水平亦呈正相关(r=6.85,P<0.01)。结论:OSAHS患儿主要危险因素有扁桃体腺样体肥大、习惯性打鼾、肥胖、张口呼吸、夜间遗尿、白天过度活跃和脾气暴躁。AI增高与呼吸紊乱有关,并且可能与全身轻度炎症反应相关。
其他摘要	Objective: To investigate the risk factors alert mechanism in children with obstructive sleep ap-nea and hypopnea syndrome (OSAHS), and to determine the correlation of arousal and systematic inlfammation response.Methods: Two hundred and eighty-ifve cases of snoring children aged 6-11 years old were included, sleep questionnaires were completed by their parents. All the children performed the whole night polysommong-raphy (PSG), the total sleep time (TST), sleep efifciency, sleep structure, oxygen desaturation, and various respi-ratory disorder index were assessed by physician. Thirty children at high risk and low risk for obstructive sleep apnea syndrome (OSAHS) were randomly selected to detect the blood routine, C reactive protein (CRP) and interleukin-1β (IL-1β) levels.Results: Fifty-six cases (19.6%) of snoring children were diagnosed OSAHS by PSG. Logistic regression analysis showed that tonsil and adenoid hypertrophy, habitual snoring, obesity, mouth breathing, enuresis, hyperactivity and irascibility were the main risk factors. PSG study showed that TST, sleep efifciency, deep sleep (stage III and IV) and REM sleep time decreased, light sleep (stage I and II), arousal index (AI), OAI, AHI and RDI increased in OSAHS children. IL-1β and CRP levels increased in OSAHS children. Pearson correlation analysis showed there was positive correlation between AI and RDI (r=7.56,P<0.01). Fur-thermore, AI correlated with the level of IL-1β (r=6.85,P<0.01).Conclusion: Tonsil and adenoid hypertrophy, habitual snoring, obesity, mouth breathing, enuresis, hyperactivity and irascibility are the main risk factors of OSAHS children. AI increases in accord with RDI and this phenomenon may correlate with systematic mild in-lfamation reponse.
资助项目	浙江省医药卫生平台骨干人才计划项目（2013RCA037）;国家重点临床专科开放课题（20130211,20130209）;浙江省科技厅科研基金资助项目（2013C33174）;浙江省自然科学基金资助项目（Y2110277）;浙江省卫生厅科研基金资助项目（2014ZDA014）
ISSN	2095-9400
卷号	45 期号:03 页码:180-184
DOI	10.3969/j.issn.2095-9400.2015.03.006
页数	5
收录类别	CNKI ; 万方 ; ISTIC
URL	查看原文
社科自定义期刊分类	G类
引用统计
文献类型	期刊论文
条目标识符	https://kms.wmu.edu.cn/handle/3ETUA0LF/49839
专题	第二临床医学院、附属第二医院、育英儿童医院研究生工作部（研究生院）
作者单位	1.温州医科大学附属第二医院育英儿童医院儿童呼吸科; 2.温州医科大学研究生院
第一作者单位	第二临床医学院，附属第二医院、育英儿童医院; 附属第二医院; 儿童呼吸科
第一作者的第一单位	第二临床医学院，附属第二医院、育英儿童医院
推荐引用方式 GB/T 7714	苏苗赏,俞晨艺,张渊博,等. 儿童OSAHS危险因素和微觉醒预警机制探讨[J]. 温州医科大学学报,2015,45(03):180-184.
APA	苏苗赏, 俞晨艺, 张渊博, 周洋洋, 徐莉, & 蔡晓红. (2015). 儿童OSAHS危险因素和微觉醒预警机制探讨. 温州医科大学学报, 45(03), 180-184.
MLA	苏苗赏,et al."儿童OSAHS危险因素和微觉醒预警机制探讨".温州医科大学学报 45.03(2015):180-184.