阻塞性睡眠呼吸暂停低通气综合征儿童认知行为异常与血清BDNF的相关性研究

发布时间：2018-07-07 10:41

  本文选题：睡眠呼吸暂停低通气综合征 + 阻塞性　； 参考：《山东大学》2014年硕士论文

【摘要】：研究目的： 通过研究儿童阻塞性睡眠呼吸暂停低通气综合征(Obstructive Sleep Apnea-hypopnea Syndrome, OSAHS)认知行为异常与血清BDNF的关系,阐释儿童OSAHS认知行为异常可能的发病机制。 研究方法： 1.选择2012年3月至2013年11月期间因睡眠时打鼾于齐鲁医院耳鼻咽喉科住院治疗的4-12岁儿童62例,经整夜多导睡眠仪(Polysomnography, PSG)监测,诊断为OSAHS40例,单纯鼾症22例,同时从小儿外科选取22例无睡眠时打鼾,并排除其他神经系统疾病的健康儿童做为健康对照组。 2.采用Conners儿童简明症状问卷评估各组儿童行为问题,问卷由各个研究对象的父母填写,问卷总分为30分,评定总和大于等于10分为认知行为异常。 3.对各组儿童行整夜PSG监测,采集并记录各项监测数据,主要监测指标有呼吸暂停低通气指数(AHI)、微觉醒指数(AI)、最低血氧饱和度(LSaO2)总睡眠时间(TST)、慢波睡眠(SWS)及REM期睡眠占总睡眠时间的比例等。 4.清晨6：30-7：00am取研究对象的空腹肘静脉血于抗凝管中,离心后收取血清后-80℃冰箱中保存,应用酶联免疫吸附法(ELISA)检测各组儿童血清中BDNF的浓度。研究结果： 1.OSAHS组及单纯鼾症组存在行为问题的比率高于健康对照组(P0.01),而两组之间无统计学差异(P0.05)。 2. OSAHS组存在行为异常的儿童REM睡眠占总睡眠时间比例(%TST)与不存在行为异常的儿童相比减少(P0.05),AI、最低血氧饱和度也有明显差异(P0.05),而AHI、SWS (%TST)无统计学差异(P0.05)。单纯鼾症组存在行为异常的儿童的AI高于不存在行为异常的儿童,而AHI、最低血氧饱和度、SWS(%TST)及REM(%TST)无统计学差异。 3.OSAHS组、单纯鼾症组BDNF水平低于健康对照组(P0.01),而两组之间无统计学差异(P0.1)。OSAHS组伴有行为异常者BDNF水平低于不伴有行为异常者(P0.01)；单纯鼾症组伴有行为异常者BDNF水平低于不伴有行为异常者(P0.05)。 结论： 1. OSAHS及单纯鼾症儿童较健康儿童有较高的认知行为异常发生率。 2.睡眠结构紊乱尤其是REM睡眠的减少、频繁觉醒以及夜间严重的血氧饱和度下降可能是OSAHSL童认知行为异常的重要原因。 3.血清BDNF水平的改变与OSAHS及单纯鼾症儿童的认知行为异常存在一定相关性,BDNF可能在包括OSAHS与单纯鼾症的SDB儿童认知行为异常的发生发展中具有重要作用。
[Abstract]:Objective: to study the relationship between cognitive behavior abnormality and serum BDNF in children with obstructive sleep Apnea-hypopnea syndrome (OSAHS), and to elucidate the possible pathogenesis of cognitive behavior abnormality in children with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: 1. From March 2012 to November 2013, 62 children aged 4-12 who were admitted to the Department of Otorhinolaryngology, Qilu Hospital for sleep snoring from March 2012 to November 2013 were diagnosed as OSAHS (40 cases) and snoring (22 cases) by overnight polysomnography (PSG) monitoring. At the same time, 22 healthy children without sleep snoring and excluding other neurological diseases were selected as the healthy control group from pediatric surgery. 2. Conners children's symptom questionnaire was used to evaluate children's behavioral problems in each group. The questionnaire was filled out by the parents of all the subjects. The total score of the questionnaire was 30 points, and the total score was more than 10. The children in each group were monitored by PSG all night, and the monitoring data were collected and recorded. The main monitoring measures were apnea hypopnea index (AHI), microarousal index (AI), minimum oxygen saturation (LSaO2) total sleep time (TST), slow wave sleep (SWS) and the proportion of REM sleep to total sleep time. The fasting elbow venous blood was collected from the subjects in the early morning. After centrifugation, the serum was collected and stored in refrigerator at -80 鈩，

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