儿童腺样体扁桃体切除前后血清炎性介质的动态变化

Changes of circulating inflammatory factors after operation in children with obstructive sleep apnea hypopnea syndrome

目的 观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿行腺样体扁桃体切除手术前、后血清中炎性因子的变化,并评估手术的影响.方法 将45例行扁桃体腺样体切除术的OSAHS患儿作为治疗组,另选45例性别和年龄等与治疗组相匹配的健康儿童为对照组.用超敏ELISA法检测血清α-肿瘤坏死因子(TNF-α)和白介素-6(IL-6),用胶乳增强免疫比浊法检测血清中超敏C-反应蛋白(hs-CRP).治疗组手术治疗后6个月复查上述指标.结果 治疗组术前血清TNF-α、IL-6和hs-CRP水平均高于对照组(P<0.01);经手术治疗后1年,上述指标均低于术前水平(P<0.01);TNF-α、IL-6和hs-CRP水平与AHI呈正相关,与LSaO2呈负相关.结论 手术治疗可有效逆转OSAHS患儿血中TNF-α、IL-6和Hs-CRP的水平,可以将其作为手术治疗效果的评价指标.

Objective To observe the changes of circulating tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) levels in children with obstructive sleep apnea-hypopnea syndrome (OSAHS) before and after operation,and to assess the effect of surgical treatment on the levels of these inflammatory factors. Methods Forty-five children with OSAHS underwent adenoidectomy and tonsillectomy were selected as OSAHS group and matched for age and sex to 45 health children control group. Serum levels of TNF-α and IL-6 were detected by high sensitivity ELISA. The hs-CRP was measured by latex-enhanced turbidometry. The serum levels of these factors in OSAHS group before operation were compared with those of the control group and OSAHS group 6 months after operation. Results Serum levels of TNF-α, IL-6, and hs-CRP in OSAHS group were higher than those in the control group (P<0.01), and the levels in OSAHS group 6 months after operation were significantly lower than those before operation (P<0.01). All the serum parameters were correlated positively with AHI, and negatively with LSaO2. Conclusions Operative treatment can effectively correct circulating serum levels of TNF-α,IL-6 and hs-CRP in children with OSAHS. The changes of TNF-α,IL-6 and hs-CRP levels can be a valuable measure in treatment follow-up.