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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。
Objective To investigate the changes of serum orexin-A levels in children with obstructive sleep apnea-hypopnea syndrome and its significance. Methods Thirty OSAHS children (OSAHS group), 20 healthy children (normal control group) and 30 obese individuals (simple obesity group) were enrolled in this study. All subjects were monitored by polysomnography and competitive enzyme-linked immunosorbent assay Analytical method (EIA) for the determination of serum orexin-A level. Results The level of serum orexin-A in OSAHS group was significantly higher than that in obese group [(0.29 ± 0.07) μg / mL, P <0.01] and normal control group (0.30 ± 0.12) μg / P <0.01]. Orexin-A levels in children with OSAHS were positively correlated with apnea-hypopnea index (AHI) and arousal index (r = 0.427,0.468, all P <0.05), and were positively correlated with LSAO2, (R = -0.527, -0.541, all P <0.01). There was no correlation between serum Orexin-A level and BMI in OSAHS group and simple obesity group (P> 0.05). Conclusion The OSAHS orexin-A level is elevated in children, which may be related to frequent awakenings during sleep, fragmentation of sleep and hypoxemia. Orexin-A may be used as a serum marker to screen suspicious patients with OSAHS.