阻塞性睡眠呼吸暂停低通气综合征患儿的心功能情况及其与病情严重程度的相关性

Cardiac function and its correlation with disease severity in children with obstructive sleep apnea hypopnea syndrome

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿的心功能情况及其与病情严重程度的相关性。方法纳入80例OSAHS患儿及100例健康儿童(对照组),根据多导睡眠监测结果将OSAHS患儿分为轻度组23例、中度组37例、重度组20例。检测所有儿童的血清肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)水平以及超声心动图参数。分析OSAHS患儿病情严重程度与生化指标、超声心动图参数之间的相关性。结果中度组、重度组患儿血清CK-MB和cTnI水平及阳性率均高于对照组,且重度组上述指标水平及阳性率高于轻度组(P<0.05);中度组和重度组的左房内径(LAD)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室短轴缩短率(LVFS)异常率及射血分数异常率均高于对照组(均P<0.05),轻度组、中度组、重度组LAD、LVESD、LVEDD均依次升高,重度组的射血分数异常率高于轻度组(均P<0.05)。OSAHS患儿的CK-MB和cTnI水平与LVESD呈正相关,与LVFS和射血分数呈负相关(均P<0.05),与LAD和LVEDD均无相关性(均P>0.05)。结论OSAHS可影响患儿的心脏功能,且病情程度越严重,心脏功能受损越明显。

Objective To investigate cardiac function and its correlation with disease severity in children with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Eighty children with OSAHS and 100 healthy children(control group)were enrolled,and OSAHS children were divided into mild group(n=23),moderate group(n=37)and severe group(n=20)according to the results of polysomnographic monitoring.All the children received detection of serum creatine kinase isoenzyme MB(CK-MB)and cardiac troponin I(cTnI)levels as well as echocardiographic parameters.The correlation of disease severity with biochemical indicators or echocardiographic parameters was analyzed in OSAHS children.Results By comparison with the control group,the moderate group and the severe group possessed higher serum levels or positive rates of CK-MB and cTnI,and the severe group had higher levels or positive rates of aforementioned indexes than the mild group(P<0.05);the moderate group and the severe group yielded higher left ventricular diameter(LAD),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD),abnormity rates of left ventricular fractional shortening(LVFS)and ejection fraction as compared with the control group(all P<0.05),LAD,LVESD and LVEDD increased in turn in the mild group,the moderate group and the severe group,the severe group reported increased abnormity rate of ejection fraction than the mild group(all P<0.05).In OSAHS children,the level of CK-MB or cTnI positively correlated with LVESD,and negatively correlated with LVFS and ejection fraction(all P<0.05),but exhibited no correlation with LAD or LVEDD(all P>0.05).Conclusion OSAHS may affect children′s cardiac function,and the impairment of cardiac function is proportional to the severity of the disease.