儿童OSAHS血浆腺苷水平及认知障碍的研究

Research of Plasma Adenosine Level and Cognitive Disorders in Children with OSAHS

目的观察儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)智力测定结果,探讨OSAHS儿童血浆腺苷(adeno-sine)水平变化及在认知功能损害中的可能作用。方法儿童OSAHS患者37例,健康对照组儿童20例,采用中国-韦氏儿童智力量表(C-WYCSI)进行智力评估,用反相高效液相色谱-紫外检测法测定血浆腺苷水平。结果儿童OSAHS组言语智商及操作智商较正常对照组低(F=13.779,P<0.01;F=13.963,P<0.01),轻度OSAHS组与中重度OSAHS组言语智商及操作智商无明显差异(P>0.05)。中重度OSAHS组血浆腺苷水平明显升高(41.9±7.7μg/L),与轻度OSAHS组与健康对照组比较有统计学意义(F=4.165,P<0.01)。结论 儿童OSAHS患者言语智商及操作智商偏低,而其血浆腺苷水平升高,提示可能是OSAHS儿童发生认知功能障碍的重要机制。

Objective To observe the intelligence results in children with obstructive sleep apnea - hypopnea syndrome（OSAHS） , also to explore the change of plasma adenosine concentration and its role in the pathophysiology of cognitive impairment in children with OSAHS. Methods Subjects were divided into Children with OSAHS （n = 37） , and control group（ n = 20）. The intelligence was as- sessed through China - merriam - webster children intelligence scale （ C - WYCSI）, and plasma adenosine levels were measured by re- verse phase high performance liquid chromatography（HPLC） of ultraviolet. Results Verbal IQ and performance IQ of children with OS- A HS was higher than that of control（ F = 13. 779, P 〈 0.01 ; F = 13. 963, P 〈 0.01 ）, but it showed no significant difference between mild OSAHS group and moderate - sever OSAHS group （ F = 4. 165, P 〈 0.01 ）. The plasma adenosine level was markedly high in moderate - severa OSHAS group（41.9 ＋ 7.7 p.g/L）, and it has a obvious statistical significance while comparing mile OSAHS group and control group （F = 4. 165, P 〈 0.01 ）. Conclusion Children with OSAHS have lower verbal IQ and performance IQ, and the plasma adenosine level is increased, which may be the main mechanism of cognitive dysfunction in children with OSAHS.