阻塞性睡眠呼吸暂停低通气综合征血清食欲素-A变化及意义研究

Study on the changes of serum orexin-A in obstructive apnea-hypopnea syndrome and its significance

目的探讨阻塞性睡眠呼吸暂停低通气综合症患儿血清食欲素-A水平的变化及意义。方法选择30名OSAHS患儿(OSAHS组)、健康儿童20名(正常对照组)和单纯肥胖者30例(单纯肥胖组),所有受试者均接受多导睡眠仪监测,采用竞争酶联免疫分析法(EIA)测定血清食欲素-A水平。结果 OSAHS组血清食欲素-A水平(0.48±0.10)μg/mL高于单纯肥胖组[(0.29±0.07)μg/mL,P<0.01]及正常对照组[(0.30±0.12)μg/mL,P<0.01]。OSAHS患儿血清Orexin-A水平与呼吸暂停低通气指数(AHI)、微觉醒指数呈正相关(r=0.427、0.468,均P<0.05),与最低血样饱和度(LSaO2)、平均血氧饱和度(MSaO2)呈负相关(r=-0.527、-0.541,均P<0.01),OSAHS组及单纯肥胖组血清Orexin-A水平与BMI无相关性(P>0.05)。结论儿童OSAHS食欲素-A水平升高,其原因可能与睡眠时频繁唤醒、睡眠片段化、低氧血症有关。食欲素-A可能作为一个血清标志物来初步筛查可疑OSAHS患儿。

Objective To explore the changes and implications of serum orexin-A levels in childrens with obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods Polysomnography was performed in 30 OSAHS children （OSAHS group） , 20 normal healthy children （control group）and 30 obese subjects （obese group）. Serum orexin-A concentration was measured with EIA kit. Results Serum orexin-A level in the OSAHS group [ （0.49 ±0.10） μg/mL] was significantly higher than that in the obese group [ （0.29 ±0.07） μg/mL,P 〈 0.01]and the control group[ （0.30± 0.12） μg/mL, P 〈 0.01 ] respectively; serum orexin-A level in children with OSAHS correlated positively with the AHI （r = 0.427, P 〈 0.05）and MAI （r = 0.468, P 〈 0.05） , but correlated negatively with the lowest oxygen saturation （LSaO2） （r = -0.527, P 〈 0.01） and the mean oxygen saturation （MSaO2） （r = -0.541, P 〈 0.01 ）, but not correlated significantly with the BMI （r = -0.212, P 〉 0.05）. Conclusion Serum orexin-A level in OSAHS children is increased, which may be caused by frequent awaking and hypoxia. The serum level of orexin-A should be used as a predictor in screening OSAHS children.