阻塞性睡眠呼吸暂停综合征患儿血清25-羟基维生素D_(3)和C反应蛋白水平变化及临床意义

Changes and clinical significance of serum 25(OH)D_(3),CRP levels in children with obstructive sleep apnea syndrome

目的:探讨阻塞性睡眠呼吸暂停综合征(OSAS)患儿血清25-羟基维生素D_(3)[25(OH)D_(3)]、C反应蛋白(CRP)水平变化及临床意义。方法:选取140例OSAS患儿作为观察组。根据呼吸暂停低通气指数(AHI)将其分为轻度组(5≤AHI≤15次/h,n=81)、中度组(16≤AHI≤30次/h,n=35)和重度组(AHI≥31次/h,n=24);另选取同期体检的140名健康儿童作为对照组。比较其血清25(OH)D_(3)、CRP水平的差异。采用多元Logistic回归和受试者工作特征曲线(ROC)综合评估25(OH)D_(3)和CRP对OSAS的诊断价值;采用Pearson相关分析探讨二者与AHI的关系。结果:与对照组相比,观察组患儿血清25(OH)D_(3)水平降低(P<0.001),CRP水平升高(P<0.001)。多元Logistic回归分析显示,25(OH)D_(3)和CRP是OSAS发病的独立影响因素(OR=0.285、2.143,P<0.05)。ROC曲线显示,25(OH)D_(3)和CRP对OSAS均有诊断价值(AUC=0.926、0.890,P<0.001)。各组25(OH)D_(3)水平比较:重度组<中度组<轻度组(P<0.05);各组CRP水平比较:重度组>中度组>轻度组(P<0.05)。Pearson相关分析显示,血清25(OH)D_(3)水平与AHI负相关(r=-0.636,P<0.001),CRP水平与AHI正相关(r=0.487,P<0.001)。结论:OSAS患儿血清25(OH)D_(3)水平降低,CRP水平升高,二者对OSAS有一定诊断价值,可用于评估病情严重程度。

Objective:To investigate the changes and clinical significance of serum 25-hydroxyvitamin D_(3)[25(OH)D_(3)],C-reactive protein(CRP)levels in children with obstructive sleep apnea syndrome(OSAS).Methods:A total of 140 children with OSAS were selected as the observation group.According to the apnea hypopnea index(AHI),they were divided into mild group(5 times/h≤AHI≤15 times/h,n=81),moderate group(16 times/h≤AHI≤30 times/h,n=35)and severe group(AHI≥31 times/h,n=24).Another 140 healthy children who underwent physical examination during the same period were selected as the control group.The basic data of all participants were recorded,the levels of serum 25(OH)D_(3) and CRP were measured,and the differences between the groups were compared.Multivariate Logistic regression and receiver operating characteristic(ROC)curve were used to comprehensively evaluate the value of each serum index in the diagnosis of OSAS,and Pearson correlation analysis was used to explore its relationship with AHI.Results:Compared with the control group,the level of serum 25(OH)D_(3) in the observation group was decreased(P<0.05),while the levels of CRP were increased(P<0.05).Multivariate Logistic regression analysis showed that 25(OH)D_(3) and CRP were independent influencing factors of OSAS(OR=0.285,2.143,P<0.05).ROC curve analysis showed that 25(OH)D_(3) and CRP had diagnostic value for OSAS(AUC=0.926,0.890,P<0.001).The level of 25(OH)D_(3) in severe group was lower than that in mild group and moderate group(P<0.05),and the levels of CRP was higher than those in mild group and moderate group(P<0.05).The level of 25(OH)D_(3) in the moderate group was lower than that in the mild group(P<0.05),and the levels of CRP was higher than those in the mild group(P<0.05).Pearson correlation analysis showed that serum 25(OH)D_(3) level was negatively correlated with AHI(r=-0.636,P<0.001),while CRP levels was positively correlated with AHI(r=0.487,P<0.001).Conclusion:The decrease of serum 25(OH)D 3 level and the increase of CRP levels in children with OSAS may be involved in the occurrence and development of OSAS.The three have certain clinical application value in the diagnosis and severity assessment of OSAS.