阻塞性睡眠呼吸暂停低通气综合征患儿血尿酸和血脂变化分析

Changes of Blood Uric Acid and Lipids in Children with Obstructive Sleep Apnea Hyperpnoea

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)儿童患儿血尿酸(UA)和血脂的变化,为OSAHS诊断及治疗提供依据。方法选择2007年3月—2010年6月我院收入的OSAHS患儿共97例,根据睡眠呼吸暂停低通气指数(AHI)将患儿分为三组:轻度组:5≤AHI<20,25例,中度组:20≤AHI<40,43例,重度组:AHI≥40,29例;另选择本院体检中心收入的健康儿童30例作为健康对照组。对各组血UA、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等指标进行检测。结果各组体质指数(BMI)间差异无统计学意义(P>0.05);轻、中、重度组OSAHS患儿BMI均高于对照组,但差异无统计学意义(q值分别为1.04、0.94、1.72,P>0.05)。各组AHI间差异有统计学意义(P<0.01);轻、中、重度组OSAHS患儿AHI均高于对照组,差异有统计学意义(q值分别为6.43、18.61、48.02,P<0.01),且AHI与OSAHS分级程度密切相关(P=0.005)。重度组OSAHS患儿UA为(272±56)umol/L,健康对照组为(229±39)umol/L,两组间比较差异有统计学意义(q=4.74,P<0.01)。但UA与OSAHS分级程度无关(P=0.853)。结论相对于健康体检儿童,重度OSAHS患儿UA水平显著增高,而OSAHS患儿的TG、TC、LDL-C、HDL-C与健康体检儿童无显著差别。UA可以作为判断OSAHS程度的指标而为临床诊断提供参考。

Objective To explore the levels of serum uric acid（UA） and blood lipids in children with obstructive sleep apnea hyperpnoea（OSAHS）,so as to provide the basis for diagnosis and treatment of OSAHS. Methods Totally 97 OSAHS children selected from March 2007 to June 2010 in our hospital were divided into three groups according to sleep apnea hypoventilation index（AHI）： mild group（5≤AHI〈20,n=25）,moderate group（20≤AHI40,n=43）,and severe group（AHI≥40,n=29）;and 30 health children from medical examination center as the controls.The levels of UA,total cholesterol（TC）,triglyceride（TG）,high density lipoprotein-cholesterol（HDL-C）,and low density lipoprotein-cholesterol（LDL-C） of each group were determined. Results The values of body mass index（BMI） in the mild group、moderate group and severe group of the OSAHS children showed no significant difference（P〉0.05）,and were higher than that in the control group,but the difference was not statistically significant（q=1.04、0.94、1.72,P〉0.05）.The differences in values of AHI among all the groups showed no statistical significance（P〈0.01）;but the values of AHI in the mild group,moderate group and severe group were statistically higher than that in the control group（q=6.43、18.61、48.02,P〈0.01）.The expression of AHI was closely related with grades of OSAHS（P=0.005）.There was a significant difference in UA value between the severe group [（272±56） umol/L] and the control group [（229±39） umol/L]（q=4.74,P〈0.01）;however,the expression of UA was no correlated with grades of OSAHS（P=0.853）. Conclusion Compared with the control group,the level of UA in severe OSAHS children is significantly higher,but the levels of TC,TG,LDL-C,and HDL-C are of no statistical difference.UA can be used as an indicator for determining the grade of OSAHS and thus provide a reference for clinical diagnosis.