CAJ | 학술논문

目的了解血浆血管内皮生长因子(vascular endothelial growth factor,VEGF)和肿瘤坏死因子α(tumor necrosis factor-alpha,TNF-α)在儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿体内的变化,探讨OSAHS患儿血浆VEGF和TNF-α水平与体质量指数(BMI)及多道睡眠图(PSG)记录数据的关系.方法 2008年10月至2009年3月中山大学附属第一医院共80例患儿纳入临床研究,其中有打鼾症状儿童60例,无打鼾症状及无OSAHS症状儿童20例为对照组.酶联免疫吸附实验(enzyme-linked immunosorbent assay,ELISA)法检测血浆VEGF和TNF-α.60例有打鼾症状儿童行PSG监测,计算每位患儿的整夜平均氧饱和度(whole night mean saturation,MSaO2)、最低氧饱和度(LSaO2)、低氧饱和事件累积时间占总睡眠时间的比率(desatuation cumulate time/total sleep time,DCT/TST)、低氧饱和度指数3(oxygen desaturation index 3,ODI3)、呼吸暂停低通气指数(AHI)、阻塞性呼吸暂停指数(obstructive apnea index,OAI).采用SPSS 13.0软件对数据进行分析.结果 OSAHS组血浆VEGF和TNF-α水平(540.45 pg/ml和311.94 pg/ml)均高于单纯鼾症组(234.45 pg/ml和97.55 pg/ml)及对照组(259.80 pg/ml和120.70 pg/ml),差异有统计学意义(HC值分别为14.176和15.571,P值均＜0.05);单纯鼾症组与对照组相比较血浆VEGF和TNF-α水平差异均无统计学意义(P值均＞0.05).OSAHS患儿血浆VEGF和TNF-α水平在中重度低氧血症组与轻度低氧血症组间差异无统计学意义(P值均＞0.05).Spearman秩相关分析发现,OSAHS患儿血浆VEGF和TNF-α水平分别与LSaO2、MSaO2、ODI3、DCT/TST、OAI、AHI以及BMI无明显相关性(r值均＜0.5,P值均＞0.05).结论 VEGF、TNF-α在OSAHS患儿体内升高,对进一步了解OSAHS患儿的病理生理改变有一定的临床意义.
목적 료해혈장혈관내피생장인자(vascular endothelial growth factor,VEGF)화종류배사인자α(tumor necrosis factor-alpha,TNF-α)재인동조새성수면호흡잠정저통기종합정(OSAHS)환인체내적변화,탐토OSAHS환인혈장VEGF화TNF-α수평여체질량지수(BMI)급다도수면도(PSG)기록수거적관계.방법 2008년10월지2009년3월중산대학부속제일의원공80례환인납입림상연구,기중유타한증상인동60례,무타한증상급무OSAHS증상인동20례위대조조.매련면역흡부실험(enzyme-linked immunosorbent assay,ELISA)법검측혈장VEGF화TNF-α.60례유타한증상인동행PSG감측,계산매위환인적정야평균양포화도(whole night mean saturation,MSaO2)、최저양포화도(LSaO2)、저양포화사건루적시간점총수면시간적비솔(desatuation cumulate time/total sleep time,DCT/TST)、저양포화도지수3(oxygen desaturation index 3,ODI3)、호흡잠정저통기지수(AHI)、조새성호흡잠정지수(obstructive apnea index,OAI).채용SPSS 13.0연건대수거진행분석.결과 OSAHS조혈장VEGF화TNF-α수평(540.45 pg/ml화311.94 pg/ml)균고우단순한증조(234.45 pg/ml화97.55 pg/ml)급대조조(259.80 pg/ml화120.70 pg/ml),차이유통계학의의(HC치분별위14.176화15.571,P치균＜0.05);단순한증조여대조조상비교혈장VEGF화TNF-α수평차이균무통계학의의(P치균＞0.05).OSAHS환인혈장VEGF화TNF-α수평재중중도저양혈증조여경도저양혈증조간차이무통계학의의(P치균＞0.05).Spearman질상관분석발현,OSAHS환인혈장VEGF화TNF-α수평분별여LSaO2、MSaO2、ODI3、DCT/TST、OAI、AHI이급BMI무명현상관성(r치균＜0.5,P치균＞0.05).결론 VEGF、TNF-α재OSAHS환인체내승고,대진일보료해OSAHS환인적병리생리개변유일정적림상의의.
Objective To investigate the relation of plasma vascular endothelial growth factor (VEGF) and tumor necrosis factor-α(TNF-α) with obstructive sleep apnea-hypopnea syndrome(OSAHS) in children.Methods Eighty children were recruited from October 2008 to March 2009,including 60 children with snoring and 20 healthy children without snoring as control.Plasma VEGF or TNF-α concentration was measured by enzyme-linked immunosorbent assay (ELISA) respectively.Sixty children with snoring underwent an overnight polysomnography test their PSG data,including whole night mean saturation (MSaO2),lowest oxygen saturation (LSaO2),desatuation cumulate time/total sleep time (DCT/TST),oxygen desaturation index 3 (ODI3),apnea-hypopnea index (AHI),obstructive apnea index (OAI),were collected and analysed.SPSS 13.0 software was used to analyze the data.Results The levels of plasma VEGF and TNF-α in children with OSAHS (540.45 pg/ml and 311.94 pg/ml) were higher than those in children with snoring alone (234.45 pg/ml and 97.55 pg/ml) or those in healthy children (259.80 pg/ml and 120.70 pg/ml),with statistically significant differences (HC value:14.176 and 15.571,P ＜ 0.05,respectively),but with no statistical difference between children with snoring alone and healthy children (P ＞ 0.05).The differences in plasma VEGF or TNF-α levels between children with moderate and severe hypoxemia and children with mild hypoxemia were not statistically significant (P ＞ 0.05).Spearman rank correlation analysis showed no significant correlation between plasma level of VEGF or TNF-α and LSaO2,MSaO2,ODI3,DCT/TST,OAI,AHI or BMI (r values were ＜0.5,P＞O.05).Conclusion Plasma levels of VEGF and TNF-α increase in children with OSAHS.