阻塞性睡眠呼吸暂停低通气综合征儿童中血清维生素D检测的意义

目的 探讨血清维生素D检测对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)儿童的临床意义。 方法 选择因打鼾症状于山东大学齐鲁医院耳鼻咽喉科治疗的儿童69例作为实验组,70例健康儿童作为对照组,化学发光免疫测定法检测139例儿童的外周血清25(OH)D水平。有打鼾症状儿童69例根据睡眠监测结果将其分为OSAHS组(47例),单纯鼾症组(22例),69例儿童采取空腹血测定血清甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,并采用Conners 父母症状问卷从品行问题、学习问题、心身障碍、焦虑、冲动-多动、多动指数方面评估两组儿童行为认知异常。 结果 (1) 对照组与单纯鼾症组、OSAHS组研究对象血清25(OH)D水平分别为(25.38±10.87)、(22.00±7.84)、(17.92±6.32)ng/mL,差异有统计学意义(F=9.458, P<0.001);OSAHS组25(OH)D水平低于对照组,差异有统计学意义(P<0.001),单纯鼾症组25(OH)D水平与对照组及OSAHS组差异均无统计学意义(P值均>0.05);(2) 肥胖(-)儿童中,OSA(+)儿童25(OH)D水平明显低于OSA(-)儿童,差异有统计学意义(P=0.001)。OSA(+)儿童中,肥胖(+)儿童与肥胖(-)儿童25(OH)D水平差异无统计学意义(P=0.566); (3) OSAHS组25(OH)D水平与焦虑呈正相关(r=0.337, P=0.020),与最低血氧饱和度(LSaO₂)、低通气指数(AHI)、品行问题、学习问题、心身障碍、冲动-多动、多动指数、TG、TC、HDL-C、LDL-C无明显相关性(r值均<0.5, P值均>0.05)。 结论 25(OH)D在OSAHS儿童体内降低,对进一步了解OSAHS儿童的病理生理改变有一定的临床意义。

Relationship between vitamin D and obstructive sleep apnea hypopnea syndrome in children

Objective To investigate the clinical significance of detecting serum vitamin D level in children with obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods During June and Octorber 2016,69 children with snoring were divided into the OSAHS group (n =47) and primary snoring (PS) group (n =22) according to the apneahypopnea index (AHI),and 70 healthy children without snoring served as controls.Venous blood was drawn from each child to measure the serum level of 25 (OH) D,triglycerides (TG),total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C).Children's behaviors were assessed with Conners Parent Symptom Questionnaire (PSQ).Results ① The mean serum 25 (OH) D level of the control,PS and OSAHS groups were 25.38 ± 10.87 ng/mL,22.00 ± 7.84 ng/mL,and 17.92 ± 6.32 ng/mL (F =9.458,P ＜0.001).There was significant difference between the OSAHS group and the control group (P ＜ 0.001),but no statistical difference between the PS group and the control group (P ＞ 0.05).② Non-obese children with OSA had significantly lower 25 (OH)D level than non-obese children without OSA (P =0.001).There were no significant difference between obese children with OSA and non-obese children with OSA (P =0.566).③ The 25 (OH) D level of the OSAHS group showed positive correlation with anxiety (r =0.337,P =0.020),but no significant correlation with AHI,PSQ,TG,TC,HDL-C and LDL-C (r ＜ 0.5,P ＞ 0.05).Conclusion The level of serum 25 (OH) D is significantly decreased in children with OSAHS,which may help to explore the pathophysiological changes of OSAHS.