超早产儿/超低出生体重儿临床结局的性别差异:一项倾向性评分匹配研究北大核心CSCD

目的通过倾向性评分匹配方法,探讨性别对超早产儿/超低出生体重儿(extremely preterm infant/extremely low birth weight infant,EPI/ELBWI)临床结局的影响。方法回顾性分析2011年1月1日至2020年12月31日住院的731例EPI或ELBWI的临床资料,将731例EPI/ELBWI分成男婴组与女婴组。通过倾向性评分匹配方法1∶1匹配,匹配变量包括:胎龄、出生体重、放弃积极治疗比例、小于胎龄儿比例、使用肺表面活性物质比例、1 min Apgar评分≤3分比例、机械通气比例、机械通气时间、产前使用疗程不足糖皮质激素比例和妊娠期高血压疾病比例,比较两组患儿住院期间主要并发症的发生率和出院存活率。结果匹配前,男婴组新生儿呼吸窘迫综合征、支气管肺发育不良、重度脑室内出血、脑室周围白质软化、坏死性小肠结肠炎、动脉导管未闭的发生率均显著高于女婴组(P<0.05);匹配后,男婴组仅支气管肺发育不良的发生率显著高于女婴组(P<0.05)。匹配前后,两组患儿的出院存活率差异均无统计学意义(P>0.05)。结论男婴EPI/ELBWI并发支气管肺发育不良的风险高于女婴,但男婴和女婴EPI/ELBWI的转归相似。     

Possible etiological factors in extensive periventricular leukomalacia of preterm infants

During a twelve-month period five cases of extensive periventricular leukomalacia (PVL) in preterm infants with a gestational age of 31-32 weeks were diagnosed by routine ultrasound screening of preterm infants. The perinatal courses and later development of these infants were compared with 12 other infants with a comparable gestational age born during the same time period. PVL babies were delivered more often by the vaginal route (p = 0.0034), and their mean highest serum total bilirubin value was significantly higher (p = 0.0054) than that of the control infants. The mean value of the highest blood pH during the first 72 hours of life was also significantly higher (p = 0.0311) in PVL babies than in control babies. On the basis of these results we speculate that in addition to ischaemia in the periventricular area, bilirubin toxicity may play an additional role in the severe damage seen in extensive periventricular leukomalacia.     

Possible Etiological Factors in Extensive Periventricular Leukomalacia of Preterm Infants

ABSTRACT. During a twelve-month period five cases of extensive periventricular leukomalacia (PVL) in preterm infants with a gestational age of 31–32 weeks were diagnosed by routine ultrasound screening of preterm infants. The perinatal courses and later development of these infants were compared with 12 other infants with a comparable gestational age born during the same time period. PVL babies were delivered more often by the vaginal route ( p =0.0034), and their mean highest serum total bilirubin value was significantly higher ( p =0.0054) than that of the control infants. The mean value of the highest blood pH during the first 72 hours of life was also significantly higher ( p =0.0311) in PVL babies than in control babies. On the basis of these results we speculate that in addition to ischaemia in the periventricular area, bilirubin toxicity may play an additional role in the severe damage seen in extensive periventricular leukomalacia.     

Assessment of antioxidant reserves and oxidative stress in cerebrospinal fluid after severe traumatic brain injury in infants and children

Studies in experimental traumatic brain injury (TBI) support a key role for oxidative stress. The degree of oxidative injury in clinical TBI, however, remains to be defined. We assessed antioxidant defenses and oxidative stress in pediatric TBI by applying a comprehensive battery of assays to cerebrospinal fluid samples. Using a protocol approved by our institutional review board, 87 cerebrospinal fluid samples from 11 infants and children with severe TBI (Glasgow Coma Scale score < or = 8) and 8 controls were studied. Cerebrospinal fluid was drained as standard care after TBI. CSF was assessed on d 1, 2, and 5-7 after ventricular drain placement. Biochemical markers of oxidative stress included F(2)-isoprostane and protein sulfhydryl (detected by ELISA and fluorescence assay, respectively). Antioxidant defenses were measured by determination of total antioxidant reserve (via chemiluminescence assay), and ascorbate (via HPLC) and glutathione (via fluorescence assay) concentrations. Free radical production (ascorbate radical) was assessed by electron paramagnetic resonance spectroscopy. F(2)-isoprostane was markedly increased versus control, maximal on d 1 (93.8 +/- 30.8 pg/mL versus 7.6 +/- 5.1 pg/mL, p < 0.05). Total antioxidant reserve was reduced versus control. Reduction was maximal on d 5-7 (81.8 +/- 3.7 microM versus 178.9 +/- 2.2 microM, p < 0.05). Ascorbate was remarkably reduced (53.8 +/- 8 microM versus 163.8 +/- 21 microM on d 1, p < 0.05). Ascorbate depletion was likely associated with its free radical oxidation, as evidenced by electron paramagnetic resonance spectroscopy. Glutathione levels increased on d 1, then decreased versus control (0.19 +/- 0.05 microM versus 1.2 +/- 0.16 microM, p < 0.05). This is the first comprehensive study of antioxidant reserve and oxidative injury in clinical TBI. Progressive compromise of antioxidant defenses and evidence of free radical-mediated lipid peroxidation are noted. These markers could be used to monitor antioxidant strategies in clinical trials.     

Early detection of delayed myelination in preterm infants

Myelination of the central nervous system can be demonstrated with magnetic resonance imaging. The influence of periventricular-intraventricular hemorrhage and periventricular leukomalacia on cerebral myelination was studied using magnetic resonance imaging. The subjects were 33 preterm infants of less than 30 weeks' gestation studied at 44 weeks' postmenstrual age: 11 infants with periventricular-intraventricular hemorrhage, 7 with periventricular leukomalacia, and 15 without periventricular-intraventricular hemorrhage or periventricular leukomalacia. There were no differences in mean gestational age and birth weight between the three groups. However, infants without periventricular-intraventricular hemorrhage or periventricular leukomalacia had significantly less respiratory distress syndrome. At 44 weeks postmenstrual age, infants with periventricular leukomalacia had a significantly delayed myelination pattern (stage M2) in comparison with infants without periventricular-intraventricular hemorrhage or periventricular leukomalacia and infants with periventricular-intraventricular hemorrhage (stages M3 and M4). The latter two groups had myelination stages that were similar to those of healthy term infants at 44 weeks' postmenstrual age. The results demonstrate that periventricular leukomalacia causes delayed myelination of the cerebrum, whereas periventricular-intraventricular hemorrhage does not.     

应用弥散张量成像评价支气管肺发育不良早产儿脑白质发育的研究

目的 应用磁共振弥散张量成像（DTI）的各项异性分数（FA）和表观弥散系数（ADC）评价支气管肺发育不良（BPD）早产儿的脑白质发育。方法 以2016年8月至2019年4月生后24 h内收住NICU的出生胎龄≤32周、出生体重<1 500 g,且出院前完成头颅MRI及DTI检查的96例早产儿为研究对象。根据出院诊断分为BPD组（n=48）和非BPD组（n=48）,比较两组DTI相同感兴趣区的FA值和ADC值。结果 两组早产儿脑室周围-脑室内出血、脑室周围白质软化、局灶性脑白质损伤等发生率差异无统计学意义（P > 0.05）。BPD组早产儿内囊后肢、胼胝体压部、枕叶白质、小脑、大脑脚的FA值低于非BPD组（P < 0.05）,各ADC值高于非BPD组（P < 0.05）。与非BPD组相比,BPD组早产儿呼吸暂停次数更多、肺炎发生率和机械通气比例更高、辅助通气时间更长（P < 0.05）。结论 BPD对早产儿脑白质发育具有潜在影响,可导致脑白质发育延迟,因此,需关注该类患儿的神经功能。     

Lower concentration of pulmonary hepatocyte growth factor is associated with more severe lung disease in preterm infants

OBJECTIVES: Hepatocyte growth factor (HGF) participates in normal lung development and in regeneration after lung injury in animals. We studied the role of HGF during the perinatal period and in the development of bronchopulmonary dysplasia (BPD). STUDY DESIGN: HGF was measured in 172 tracheal aspirate fluid samples (TAF) from 17 preterm infants in whom BPD subsequently developed (gestational age, 27.2+/-1.7 weeks; body weight, 828+/-210 g) and from 15 who survived without BPD (gestational age, 26.8+/-1.9 weeks; body weight, 994+/-265 g) during the first 2 postnatal weeks. RESULTS: Infants with subsequent development of BPD had lower HGF in TAF (45+/-9 pg/mL per IgA-sc) than those surviving without BPD (102+/-32 pg/mL per IgA-sc; P=.028). Lower HGF in TAF were seen in infants with more severe acute respiratory distress as defined as requirement for surfactant therapy (50+/-14 vs 146+/-50 pg/mL per IgA-sc in infants requiring no surfactant; P=.0001), for higher number of surfactant doses (r=-0.16, P=.06), and for mechanical ventilation >1 week (167+/-51 vs 51+/-14 pg/mL per IgA-sc in infants intubated <1 week; P=.0012). CONCLUSIONS: These data show an association between lower HGF concentration in TAF and more severe lung disease in human preterm infants in the early neonatal period.     

Inflammatory markers in intrauterine and fetal blood and cerebrospinal fluid compartments are associated with adverse pulmonary and neurologic outcomes in preterm infants

Recent evidence strongly implicates the inflammatory response to intrauterine infection in the pathogenesis of neonatal brain and lung injury. We hypothesized that lung and brain injury in preterm infants occurs during a common developmental window of vulnerability as the result of an inflammatory response in different compartments. To determine whether inflammatory markers in these compartments are associated with bronchopulmonary dysplasia (BPD) or cranial ultrasound (CUS) abnormalities in infants <33 wk gestation age (GA) and <1501 g birth weight, we analyzed placental pathology and serum and cerebrospinal fluid (CSF) IL-6, IL-1beta, and tumor necrosis factor-alpha (TNF-alpha) concentrations in 276 infants. Logistic regressions were performed stratified by GA. Histologic chorioamnionitis was significantly associated with BPD in infants /=17 pg/mL was associated with an abnormal CUS in infants >28 wk GA (OR 3.36, p = 0.023) but not /=6.5 pg/mL and TNF-alpha >/=3 pg/mL were associated with abnormal CUS in infants /=28 wk GA. These data suggest that in infants 相似文献   

心肌缺血大鼠血浆8-异前列腺素F_(2α)水平及N-乙酰半胱氨酸干预作用(英文)

目的　8 异前列腺素F2α(8 iso PGF2α)是一种敏感、特异性反映缺血 再灌注后氧自由基增加的生 化指标。抗氧化剂N 乙酰半胱氨酸(NAC)具有清除氧自由基的作用。本研究旨在分析实验性心肌缺血大鼠血浆 与心肌8 iso PGF2α相关性以及NAC的治疗效果,探讨血浆8 iso PGF2α反映心肌氧自由基损伤程度的可能性和 NAC的干预效果。方法　45只雄性成年Wistar大鼠随机分为3组(每组15只):对照组、缺血组和NAC组。缺血 组和NAC组腹腔注射垂体后叶素(20U/kg)制成大鼠急性心肌缺血模型,以心电图上ST段的抬高作为心肌缺血 的指标。对照组仅腹腔注射生理盐水。NAC组缺血前2周开始用NAC(每日0.1g/kg)灌胃,共3周。应用ELISA 方法测定各组大鼠血浆及心肌组织8 iso PGF2α含量。结果　缺血组大鼠的血浆和心肌组织含量分别为(187.1± 45.8)pg/mL和(259.3±47.5)pg/g,明显高于正常对照组(60.4±13.7)pg/mL和(88.6±16.9)pg/g (P<0.01);NAC组的血浆和心肌组织8 iso PGF2α含量为(88.2±16.4)pg/mL和(109.4±24.7)pg/g明显低于 缺血组(P<0.01)。血浆与心肌8 iso PGF2α水平相关(r=0.856,P<0.01)。与正常组比较,缺血组的心电图 ST段明显抬高(心肌缺血45min时抬高最为明显,达0.34±0.05mV)(P<0.05);NAC组大鼠心     

Association of septic shock caused by early-onset group B streptococcal sepsis and periventricular leukomalacia in the preterm infant

Early-onset group B streptococcal sepsis frequently produces shock in preterm infants, a condition also felt to be contributory to the development of periventricular leukomalacia. During a 2-year study period, 628 preterm infants who were admitted to the neonatal intensive care unit underwent serial sonographic brain scanning; periventricular leukomalacia was diagnosed in eight infants (1.2%). The four infants (100%) who survived group B streptococcal sepsis with septic shock developed periventricular leukomalacia, whereas none of the four survivors (0%) of septic shock caused by other organisms and three of 27 survivors (11%) of shock not caused by infection developed periventricular leukomalacia. Because of the frequency of this lesion, it is suggested that all preterm survivors of group B streptococcal sepsis with septic shock should have serial sonography screening for detection of periventricular leukomalacia. Early detection will not assure cure but may facilitate prognostication, follow-up, and earlier institution of rehabilitative therapy to produce a better outcome.     

Hyperbilirubinemia, hypocarbia and periventricular leukomalacia in preterm infants: relationship to cerebral palsy

This study comprised 103 preterm infants with a gestational age less than 33 weeks who were born in Tampere University Hospital and who were followed up to two years of age. Sixty-four perinatal variables were compared to ultrasound findings in the neonatal period and neurologic handicap at the age of two years. Duration of hypocarbia (PCO2 < or = 30 mmHg) during the first 72 h and hyperbilirubinemia (the mean level of serum total bilirubin) at three days of age were independently and significantly related to periventricular leukomalacia, but not directly to cerebral palsy. The only perinatal variables related independently and significantly to cerebral palsy at two years of age were periventricular leukomalacia and ventriculomegaly. According to these results, periventricular leukomalacia was the main predictor of cerebral palsy in preterm infants. In addition to hypocarbia, hyperbilirubinemia may also be involved in the pathogenesis of extensive (severe cystic) periventricular leukomalacia.     

Hypocarbia in the ventilated preterm infant and its effect on intraventricular haemorrhage and bronchopulmonary dysplasia

OBJECTIVE: To examine the relationship between PaCO2 levels in ventilated very preterm infants and (i) the incidence of severe intraventricular haemorrhage (IVH) and periventricular leukomalacia (PVL); and (ii) bronchopulmonary dysplasia (BPD). METHODS: A retrospective cohort analysis of preterm infants comparing PaCO2 levels with the incidence of severe IVH/PVL and BPD was carried out on patients born at less than 29 weeks gestation from 1992 to 1994 and admitted to the tertiary neonatal intensive care unit at the King Edward Memorial Hospital (314 infants). During the first 96 h, PaCO2 levels were examined including lowest and highest PaCO2 levels, mean PaCO2 levels and duration of hypocarbia both pre- and post-surfactant administration. RESULTS: Of the 314 infants, there were 40 early neonatal deaths (less than 48 h) who were not included in the analysis. Of the 274 surviving infants, 72 (26%) infants had severe IVH. Infants whose PaCO2 fell below 30 mmHg at any stage in the first 48 h of life had an increased risk of severe IVH or PVL (odds ratio 2.38; 95% CI 1.27-4.49; P = 0.007). Of the 265 survivors to 36 weeks corrected gestational age, 134 (51%) had BPD. Infants with at least three PaCO2 values less than 30 mmHg in the first 24 h of life had an increased risk of BPD (odds ratio 2.21; 95% CI 1.05-4.57; P = 0.036). CONCLUSIONS: The risk of severe IVH/PVL was significantly increased by hypocarbia. There was also an association between hypocarbia and BPD, particularly when hypocarbia was prolonged. These findings suggest that avoidance of hypocarbia may reduce the incidence of severe IVH/PVL and BPD in preterm infants.     

支气管肺发育不良早产儿早期肺外合并症的临床分析

目的 通过对支气管肺发育不良(bronchopulmonary dysplasia,BPD)早产儿生后早期脑室周围-脑室内出血(periventricular intraventricular hemorrhage,PVH-IVH)、脑白质损伤、胃肠外营养相关性胆汁淤积综合征(parenteral nutrition associated cholestasis,PNAC)及代谢性骨病发病情况的临床分析,以期对BPD患儿肺外并发症的预防和监测进行指导.方法 回顾性分析2014年9月至2015年12月于中国医科大学附属盛京医院新生儿病房住院并明确诊断BPD的87例早产儿(BPD组),随机选择同期住院非BPD早产儿90例为对照组(非BPD组),分析两组PVH-IVH、脑白质损伤、PNAC及代谢性骨病等肺外并发症的发生率.结果 BPD组早产儿PVH-IVH发病率[26.4%(23/87)]高于非BPD组[11.1%(10/90)] (P＜0.01),其中BPD组Ⅰ~Ⅱ级PVH-IVH发病率也明显升高[24.1%(21/87) 比 11.1%(10/90)](P＜0.05),而Ⅲ~Ⅳ级PVH-IVH发生率两组比较差异无统计学意义(P＞0.05).BPD组早产儿脑白质损伤发生率[33.3%(29/87)]明显高于非BPD组[16.7%(15/90)] (P＜0.05),其中的严重类型脑室周围白质软化的发生率BPD组也明显增高[13.7%(12/87) 比 2.2%(2/90)](P＜0.05).此外,BPD组早产儿PNAC[22.9%(20/87) 比 5.5%(5/90)]、代谢性骨病[17.2%(15/87) 比 3.3%(3/90)]及代谢性骨病中有影像学改变[6.9%(6/87) 比 0]的发生率均高于非BPD组,差异均有统计学意义(P＜0.05).结论 BPD患儿较非BPD早产儿更易合并PVH-IVH、脑白质损伤、PNAC及代谢性骨病等早期肺外并发症,生后早期合理预防及定期监测肺外并发症的发生对提高BPD患儿生存质量至关重要.     

应用弥散张量成像评价支气管肺发育不良早产儿脑白质发育的研究

目的 应用磁共振弥散张量成像（DTI）的各项异性分数（FA）和表观弥散系数（ADC）评价支气管肺发育不良（BPD）早产儿的脑白质发育。方法 以2016年8月至2019年4月生后24 h内收住NICU的出生胎龄≤32周、出生体重<1 500 g,且出院前完成头颅MRI及DTI检查的96例早产儿为研究对象。根据出院诊断分为BPD组（n=48）和非BPD组（n=48）,比较两组DTI相同感兴趣区的FA值和ADC值。结果 两组早产儿脑室周围-脑室内出血、脑室周围白质软化、局灶性脑白质损伤等发生率差异无统计学意义（P > 0.05）。BPD组早产儿内囊后肢、胼胝体压部、枕叶白质、小脑、大脑脚的FA值低于非BPD组（P < 0.05）,各ADC值高于非BPD组（P < 0.05）。与非BPD组相比,BPD组早产儿呼吸暂停次数更多、肺炎发生率和机械通气比例更高、辅助通气时间更长（P < 0.05）。结论 BPD对早产儿脑白质发育具有潜在影响,可导致脑白质发育延迟,因此,需关注该类患儿的神经功能。     

支气管肺发育不良早产儿血清YKL-40和HMGB1水平的变化

目的 探究早产儿生后外周血人软骨糖蛋白-39（YKL-40）、高迁移率族蛋白1（HMGB1）水平动态变化与支气管肺发育不良（BPD）的关系。方法 前瞻性选择2017年7月至2019年8月新生儿重症监护室收治的出生胎龄≥ 28周且<32周、出生体重<1 500 g的早产儿,根据诊断分为BPD组（n=35）和非BPD组（n=51）。通过酶联免疫吸附法检测早产儿生后第3、7、14天血清YKL-40和HMGB1浓度并进行比较。结果 BPD组第3、7、14天血清YKL-40浓度均低于非BPD组（P < 0.001）,HMGB1浓度均高于非BPD组（P < 0.001）。两组第7、14天血清YKL-40及HMGB1浓度均高于第3天（P < 0.017）。BPD组第14天HMGB1浓度高于第7天（P < 0.017）,第7、14天YKL-40浓度差异无统计学意义（P > 0.017）。非BPD组第14天YKL-40浓度高于第7天（P < 0.017）,第7、14天HMGB1浓度差异无统计学意义（P > 0.017）。结论 BPD及非BPD早产儿生后第3、7、14天外周血中YKL-40及HMGB1水平存在差异,两者可能与BPD的形成相关。     

Prevalence of neonatal ultrasound brain lesions in premature infants with and without intrauterine growth restriction

AIM: To compare the prevalence of transient periventricular echodensities (TPE), periventricular leukomalacia (PVL) and haemorrhagic brain lesions (HBL) in singleton intrauterine growth-restricted (IUGR) infants and in those appropriate for gestational age (AGA). METHODS: Thirty-five IUGR and 35 AGA singleton infants born between 24- and 34-week gestational age were studied. The presence of TPE, PVL and HBL was assessed with ultrasound (US) at day 3 (US-I), 2 weeks (US-II) after delivery and at term-equivalent age (US-III). RESULTS: IUGR neonates had an increased prevalence of TPE at US-I (18/35 vs. 8/35, p= 0.02) and an increased prevalence of PVL at US-II (8/32 vs. 1/31, p = 0.03) and US-III (8/29 vs. 1/29, p = 0.02). No significant differences in the prevalence of HBL were found between the two groups. CONCLUSIONS: IUGR is associated with an increased prevalence of white matter damage on US brain scans in preterm neonates.     

Etiological factors associated with the development of periventricular leukomalacia

Prenatal, intrapartum and postnatal factors are compared between 15 preterm infants, known to have periventricular leukomalacia (PVL) on ultrasound and 15 infants of similar birthweight and gestation who ultrasonographically showed no evidence of cystic lesions, and who are known to be neurologically normal at follow up. Prenatally, the incidence of antepartum haemorrhage was significantly higher in the PVL group. Intrapartum factors were similar between the two groups but postnatally, the PVL group had significantly lower PaCO2 readings during the first 72 h of life. It is postulated that a severe maternal bleed in late pregnancy and neonatal hypocarbia could significantly decrease cerebral perfusion and cause areas of ischaemia and infarction resulting in periventricular leukomalacia.     

Etiological Factors Associated with the Development of Periventricular Leukomalacia

ABSTRACT. Prenatal, intrapartum and postnatal factors are compared between 15 preterm infants, known to have periventricular leukomalacia (PVL) on ultrasound and 15 infants of similar birthweight and gestation who ultrasonographically showed no evidence of cystic lesions, and who are known to be neurologically normal at follow up. Prenatally, the incidence of antepartum haemorrhage was significantly higher in the PVL group. Intrapartum factors were similar between the two groups but postnatally, the PVL group had significantly lower PaCO₂ readings during the first 72 h of life. It is postulated that a severe maternal bleed in late pregnancy and neonatal hypocarbia could significantly decrease cerebral perfusion and cause areas of ischaemia and infarction resulting in periventricular leukomalacia.     

Lactoferrin and lysozyme deficiency in airway secretions: association with the development of bronchopulmonary dysplasia.

To test whether the presence of airway inflammatory markers differentiated babies with hyaline membrane disease (HMD) who recovered (n = 18) from those in whom bronchopulmonary dysplasia (BPD) developed (n = 18), tracheal aspirate samples from 36 newborn infants with HMD who underwent intubation were collected during days 1 to 28 of life and analyzed for the mucosal antimicrobial proteins lactoferrin and lysozyme. For babies with HMD in whom BPD developed, lactoferrin concentrations were decreased during the first 4 days of life (7 +/- 3, 14 +/- 3, 18 +/- 3, and 18 +/- 3 micrograms/ml, respectively) in comparison with those in babies with HMD who recovered (23 +/- 8, 29 +/- 6, 41 +/- 9, and 81 +/- 19 micrograms/ml); group differences reached statistical significance on days 3 and 4 (p less than 0.05). Lysozyme levels in the secretions of babies with BPD were also lower on day 3 (31 +/- 5 micrograms/ml) than in those of babies who recovered (54 +/- 7.5 micrograms/ml). For babies with BPD whose endotracheal tube remained in place beyond day 4, lysozyme levels on days 5 to 12 were significantly lower for those classified as having severe BPD than for those with mild to moderate BPD. Because lysozyme and lactoferrin are products of serous cells found in submucous glands, it seems possible that the relative immaturity of submucous glands may influence the development of BPD.     

Correlation of 8-isoprostane, interleukin-6 and cardiac functions with clinical score in childhood obstructive sleep apnoea

Abstract Objective: Adeno-tonsillar hypertrophy is the commonest cause of childhood obstructive sleep apnoea (OSA). Our aim of the study is to correlate the severity of OSA with levels of 8-isoprostane and interleukin-6 (IL-6) and with cardiac diastolic dysfunctions. Methods: Forty children with adenoidal hypertrophy and 20 control children were recruited. The OSA clinical score was evaluated and IL-6 and 8-isoprostane were measured in exhaled breath condensate. The cardiac functions were evaluated by conventional and tissue Doppler echocardiography (TDE). Results: Higher concentrations of isoprostane-8 and IL-6 were found in group with clinical score >40 (58.595 +/- 2.86 pg/mL and 38 +/- 1.77 pg/mL, respectively) than in control group (34.9 +/- 1.5 pg/mL and 7.02 +/- 0.3 pg/mL, respectively) {p < 0.0001*}. There was positive correlation between level of isoprostane-8 and IL-6 and value of clinical score {p < 0.0001*} and also with the degree of the cardiac dysfunction in those children. Conclusion: The severity of OSA as indicated by clinical score was positively correlated with degree of elevation of 8-Isoprostane and IL-6 in breath condensate of children with OSA and also with degree of cardiac dysfunction. Echocardiography and tissue Doppler modality are advised to examine these children.