摘要
目的探讨睡眠呼吸暂停综合征(obstructivesleepapnea—hypopneasyndrome,OSAHS)儿童手术治疗前后血浆食欲素A(Orexin—A)水平变化及与感觉统合能力的关系。方法接受扁桃体切除和/或腺样体刮除术的儿童OSAHS患者120例,正常对照组30例。并按呼吸暂停低通气指数(apneahypopneain—dex,AHI)将OSAHS组分为轻度组(5次/h≤AHI〈20次/h,n=13);中度组(20次/h≤AHI〈40次/h,n=76);重度组(AHII〉40次/h,n=31)。同时按感觉统合能力评分还将OSAHS组分为正常组30名、轻度失调组47名、中度失调组28名、重度失调组15名。术前及术后6个月进行血浆Orexin—A水平测定及儿童感觉统合能力评定。结果OSAHS组患儿血浆Orexin—A浓度[(0.41±0.06)μ/ml]高于正常对照组[(0.31±0.04)μg/ml],差异有统计学意义CP〈0.01);不同严重程度OSAHS患儿手术前后血浆Orexin—A浓度比较,轻度组[术前(0.33±0.02)μg/ml,术后(0.28±0.03)μ/ml]、中度组[术前(0.39±0.04)μ/ml,术后(0.29±0.03)μ/ml]、重度组[术前(0.49±0.04)μ/ml,术后(0.32±0.02)μg/ml]差异均有统计学意义(P〈0.01)。AHI指数与术前血浆Orexin—A浓度显著相关(r=0.803,P〈0.01)。感觉统合测评分值与术前血浆Orexin—A浓度也存在显著相关(r=-0.812,P〈0.01)。结论血浆Orexin—A浓度与儿童OSAHS严重程度及其行为认知能力改变关系密切,可能成为儿童OSAHS诊断和预后的血浆标志物。
Objective To explore the changes of plasma orexin-A level before and after operation in ob- structive sleep apnea-hypopnea syndrome (OSAHS) children and its effect on their behavior performance. Methods 120 cases OSAHS children performed tonsillectomy and / or adenoidectomy and 30 cases normal children as con- trol group. According to the AHI index, the OSAHS group was divided into mild group (5 times/h ≤ AHI 〈 20 times/h, n= 13) ,moderate group (20/h ≤AHI 〈40/h, n=76) ,and severe group (AHI /〉 40 times/h, n=31). And at the same time, according to the sensory integration ratings, OSAHS group was divided into normal group( n = 30), mildly abnormal group ( n = 47 ), moderately abnormal group ( n = 28 ), severely abnormal group ( n = 15 ). Before operation and 6 months after operation, plasma orexin-A levels and children's sensory integration were meas- ured.Results Plasma orexin-A level of the OSAHS group ( ( 0.41±0.06) μg/ml) was significantly higher com- pared with the control group ( (0.31 ±0.04) μg/ml) (P〈 0.01 ). In orexin-A level of different A HI groups before and after operation(mild group: (0.33±0.02) μg/ml vs (0.28±0.03) μg/ml, moderate group: (0.39±0.04) μg/ml vs ( 0.29±0.03 ) μg/ml, severe group: (0.49±0.04) μg/ml vs ( 0.32±0.02 ) μg/ml), there had significant differences (P〈0.01) .In OSAHS children,AHI index had positive correlation with preoperative plasma orexin-A level ( r= 0.803, P〈0.01 ). There was a significant negative correlation between sensory integration scores and plasma orexin- A level( r=-0.812, P〈0.01). Conclusions Plasma orexin-A level of OSAHS children is closely related to the severity of OSAHS and the changes of their behavioral ability.And it may become a diagnostic plasma marker of OSAHS children.
出处
《中华行为医学与脑科学杂志》
CAS
CSCD
北大核心
2013年第11期989-991,共3页
Chinese Journal of Behavioral Medicine and Brain Science
基金
基金项目:深圳市科技计划项目(201002032
201102077)
关键词
睡眠呼吸暂停综合征
食欲素A
感觉统合能力
Obstructive sleep apnea-hypopnea syndrome
Orexin-A
Sensory integration capacity