阻塞性睡眠呼吸暂停低通气综合征血清食欲素-A变化及意义研究

摘要：目的　探讨阻塞性睡眠呼吸暂停低通气综合症患儿血清食欲素-A水平的变化及意义 。方法　选择30名OSAHS患儿（ OSAHS组）、健康儿童20名（正常对照组）和单纯肥胖者30例（单纯肥胖组），所有受试者均接受多导睡眠仪监测，采用竞争酶联免疫分析法（EIA）测定血清食欲素-A水平。结果　OSAHS组血清食欲素-A水平（0.48±0.10） μg/mL 高于单纯肥胖组［（0.29±0.07） μg/mL，P < 0.01］及正常对照组［（0.30±0.12） μg/mL，P < 0.01］。OSAHS患儿血清Orexin-A水平与呼吸暂停低通气指数（AHI）、微觉醒指数呈正相关（r = 0.427、0.468，均 P < 0.05），与最低血样饱和度（LSaO2）、平均血氧饱和度（MSaO2）呈负相关（r = -0.527、-0.541 ，均P < 0.01），OSAHS组及单纯肥胖组血清Orexin-A水平与BMI无相关性（P > 0.05）。结论　儿童OSAHS食欲素-A水平升高，其原因可能与睡眠时频繁唤醒、睡眠片段化、低氧血症有关。食欲素-A可能作为一个血清标志物来初步筛查可疑OSAHS患儿。

Study on the changes of serum orexin-A in obstructive apnea-hypopnea syndrome and its significance.

Abstract：Objective　To explore the changes and implications of serum orexin-A levels in childrens with obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods　Polysomnography was performed in 30 OSAHS children （OSAHS group）， 20 normal healthy children （control group）and 30 obese subjects （obese group）. Serum orexin-A concentration was measured with EIA kit. Results　Serum orexin-A level in the OSAHS group ［（0.49±0.10） μg/mL］ was significantly higher than that in the obese group ［（0.29±0.07） μg/mL，P < 0.01］and the control group［（0.30±0.12） μg/mL，P < 0.01］respectively； serum orexin-A level in children with OSAHS correlated positively with the AHI（r = 0.427， P < 0.05）and MAI （r = 0.468， P < 0.05）， but correlated negatively with the lowest oxygen saturation （LSaO2） （r = -0.527， P < 0.01） and the mean oxygen saturation （MSaO2） （r = -0.541， P < 0.01），but not correlated significantly with the BMI （r = -0.212， P > 0.05）. Conclusion　Serum orexin-A level in OSAHS children is increased， which may be caused by frequent awaking and hypoxia. The serum level of orexin-A should be used as a predictor in screening OSAHS children.