扁桃体腺样体切除术对睡眠呼吸障碍儿童血清C反应蛋白的影响

Serum C-reactive protein in children with sleep-disordered breathing before and after adenotonsillectomy

目的探讨扁桃体腺样体切除术对睡眠呼吸障碍(SDB)儿童全身炎症的治疗作用。方法采用多导睡眠仪,对65例睡眠打鼾儿童进行整夜睡眠监测,并应用conners简明症状问卷评定儿童行为问题。比较阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与单纯鼾症儿童行手术前和手术1年后血清C反应蛋白水平的变化以及异常行为的改善情况。结果无论血清C反应蛋白含量还是Conners行为简明症状问卷得分在OSAHS儿童明显高于单纯鼾症及健康对照儿童;单纯鼾症儿童也明显高于健康对照组。在OSAHS组Conners行为简明症状问卷评分由行扁桃体腺样体手术前的14.2±3.8下降到手术后6.7±3.1,血清C反应蛋白含量由术前的(4.25±1.78)mg/L下降到术后的(3.23±1.45)mg/L(P<0.05),差异有统计学意义;单纯鼾症组Conners行为简明症状问卷评分由术前的9.4±4.1下降到术后5.1±2.8,血清C反应蛋白含量由术前的(2.77±1.80)mg/L下降到术后的(1.76±0.81)mg/L(P<0.05),差异有统计学意义。结论SDB儿童有较多的行为问题出现以及较高的血清C反应蛋白水平。扁桃体腺样体切除术对SDB儿童行为异常有明显的治疗作用,同时血清C反应蛋白水平也明显的下降。

Objective To find the therapeutical effect of systemic inflammation in sleep-disordered breathing（SDB） children after adnotonsillectomy. Methods Polysonmography monitoring was performed in 65 snoring children all night and Conners concise questionnaire was applied to assess children＇s behavior symptoms. The change of serum C-reactive protein levels and improvement in abnormal behavior were compared in obstructive sleep apnea-hypopnea syndrome（OSAHS） children and primary snoring children before and 1 year after adnotonsillectomy. Results The Conner＇s concise symptom questionnaire behavior score and serum C-reactive protein content of children with OSAHS were significantly higher than those of primary snoring children and healthy control children; and the two above indicators were also significantly higher in primary snoring children than in healthy control children. After adnotonsillectomy the score in Conners concise symptom questionnaire of OSAHS children was decreased form 14.2 ± 3.8 to 6.7 ± 3.1 （ P 〈 0.05）, and the serum C-reactive protein was decreased from （4.25 ± 1.78） mg/L to （3.23 ±0.45）mg/L（ P 〈0.05）. The score of abnormal behavior in the primary snoring group was decreased from 9.4 ± 4.1 to 5.1± 2.8 （ P 〈 0.05） ; the serum C-reactive protein concentration fell from （2.77 ± 1.80） mg/L to （ 1.76 ± 0.81 ） mg/L（ P 〈 0.05）. Conclusion OSAHS and primary snoring children are frequently associated with increases of CRP levels and a lot of behavior disorder problems, and those indicators and symptoms can become reversible after treatment by adnotonsillectomy.