儿童阻塞性睡眠呼吸暂停低通气综合征患者骨龄和血清骨钙素的测定分析

Determination and analysis of serum osteocalcin and bone age in children with obstructive sleep apnea hypopnea syndrome

目的通过对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿骨龄、血清骨钙素水平、身高、体质量等参数的测定分析,探讨OSAHS对儿童患者生长发育,尤其是对骨骼生长发育的影响。方法根据就诊儿童病史、症状、体征及多导睡眠仪监测结果,选择OSAHS患儿29例为实验组,同时选择无睡眠打鼾和呼吸障碍的健康儿童13例作为对照组。两组儿童均拍摄左手正位X线片测算骨龄,抽取空腹血测定血清骨钙素水平,同时对身高、体质量等指标进行测算。结果 OSAHS实验组骨龄(6.31±1.12)岁,对照组骨龄(6.45±1.57)岁,差异无统计学意义(t=0.15,P>0.05);但两组的骨龄与实际年龄的差值之间的差异有统计学意义(t=8.07,P<0.05)。实验组血清骨钙素(7.41±0.31)μg/L,对照组(10.22±0.50)μg/L,差异有统计学意义(t=10.17,P<0.05)。结论 OSAHS患儿骨龄相对偏低,血清骨钙素含量低于正常儿童,表明OSAHS可以影响儿童骨骼的生长发育,从而影响身高体质量的生长发育。

Objective To study the influence of obstructive sleep apnea hypopnea syndrome on children′s growth,especially on their bone growth,by the determinations and analysis of the serum osteocalcin level and bone age,including height,weight and an other parameters.Methods 29 children,diagnosed as OSAHS according to their history,physical examination and polysomnography,were enrolled in the experimental group and the another 13 children without sleep snoring and dyspnoea were enrolled into the control group.Anteroposterior（AP） X-ray film was taken of the left wrist to assess bone age,and the serum osteocalcin was measured in a fasting blood sample.Also,the height and weight data of children were measured.Results The bone age in the experimental and control group were 6.31＋1.12,and 6.45＋1.57 years,respectively（t=0.15,P0.05）.The D-values in the bone age and the real age for the two groups showed a significant difference（t=8.07,P0.05）.The serum osteocalcin was 7.41＋0.31 μg/L in the experimental group,and 10.22＋0.50 μg/L in the control group（t=10.17,P0.05）.Conclusion Compared with the controls,the bone age of children with OSAHS was lower and the serum osteocalcin level was decreased,which indicated that OSAHS probably exerts influence on bone growth.