儿童阻塞性睡眠呼吸暂停低通气综合征免疫状态的评估

发布时间：2018-03-16 05:23

  本文选题：阻塞性睡眠呼吸暂停低通气综合征　切入点：儿童　出处：《浙江大学》2012年硕士论文　论文类型：学位论文

【摘要】：背景及目的： 阻塞性睡眠呼吸暂停低通气综合征(Obstructive Sleep Apnea-hypopnea Syndrome, OSAHS)是以睡眠间断性上气道部分或完全梗阻为特点的睡眠呼吸紊乱,可以发生在从新生儿到青春期的各个年龄阶段,总体发病率为1-4%。OSAHS患儿由于呼吸气流改变、夜间反复发生低氧血症、二氧化碳潴留及反复觉醒等原因引起患儿多系统的损害,造成患几生长发育落后、心脏功能改变、传导性耳聋、颜面发育畸形、记忆力减退、智力下降及性格改变等多种严重并发症。儿童OSAHS在2-6岁出现发病的高峰,这与腺样体及扁桃体生理性肥大密切相关。关于阻塞性睡眠呼吸暂停低通气综合征对儿童免疫系统功能影响的研究国内尚不多,且多局限于体液免疫或者细胞免疫中的一种。本研究拟通过采集外周静脉血进行T细胞亚群、免疫球蛋白、补体及细胞因子分析的方法,探讨OSAHS对患儿体液免疫及细胞免疫的影响。 资料与方-法： 选择2010年5月至2011年8月,50例在我科住院的OSAHS患儿。该组患几平均年龄79.38m(47m-148m),其中男40例,女10例。所有患儿均在入院后通过整夜睡眠监测确诊。正常对照组52例,年龄平均77.13m(36m-143m),男33例,女19例。该组为无相关性疾病及全身性疾病的体检儿童。入院后采集外周静脉血,分析采用美国Becton Dickinson (BD) FACSCalibur流式细胞仪及西门子公司BN Ⅱ免疫分析仪。检测指标包括：CD3+, CD4+, CD8+, IgA, IgG, IgM, IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ. 结果： OSAHS组,CD8+T淋巴细胞所占百分比明显高于对照组(26.47±5.52vs.23.974±4.92),差异有显著意义(P=0.017)。CD4+/CD8+比值明显低于对照组(1.24±0.38vs.1.45±0.41),有显著差异(P=0.006)。OSAHS组,患儿血清IgA含量明显高于对照组(1.63±1.01g/L vs.1.07±±0.48g/L),有显著差异(P=0.000)。OSAHS组患儿血清C3含量明显高于对照组(1.17±0.23g/L vs.1.03±0.15g/L),有显著差异(P=0.001)。OSAHS组,患儿血清IL-4含量明显高于对照组[2.45(0.60、7.90)pg/mL vs.1.25(0.60、4.80) pg/mL],有显著差异(P=0.000)。OSAHS组患儿血清IL-6含量明显高于对照组[3.75(1.50、36.50)pg/mL vs.2.50(1.20、37.90)pg/mL],有显著差异(P=0.009). OSAHS组患儿血清IL-10含量明显高于对照组[3.45(1.80、16.40) pg/mL vs.3.10(1.50、6.30) pg/mL],有显著差异(P=0.001)。OSAHS组患儿血清IFN-y含量明显高于对照组[4.40(1.00、16.60)pg/mL vs.2.65(1.00、24.50) pg/mL],有显著差异(P=0.003)。 结论： OSAHS患儿CD8+T淋巴细胞所占百分比上升,CD4+/CD8+比值降低,存在细胞免疫功能低下,体液免疫指标IL-4, IL-6, IL-10, IFN-γ上升,提示机体处于氧化应激和全身炎症状态。
[Abstract]:Background and purpose:. Obstructive Sleep Apnea-hypopnea Syndrome (OSAHS) is a sleep apnea disorder characterized by intermittent partial or complete upper airway obstruction, which can occur at all ages from newborn to puberty. The overall incidence of OSAHS was 1-4. The respiratory and airflow changes, recurrent hypoxemia at night, carbon dioxide retention and repeated arousal caused multiple system damage, resulting in a number of poor growth and development, and changes in heart function. Conductive deafness, facial deformity, memory loss, mental retardation and personality change are serious complications. The onset of OSAHS peaks in children aged 2 to 6. This is closely related to the physiological hypertrophy of adenoids and tonsils. There are few studies on the effects of obstructive sleep apnea hypopnea syndrome on the immune system in children. This study was designed to collect peripheral venous blood for T cell subsets, immunoglobulin, complement and cytokine analysis. To investigate the effect of OSAHS on humoral immunity and cellular immunity in children. Information and Fangfa:. From May 2010 to August 2011, 50 patients with OSAHS in our department were selected. The average age of these patients was 79.38mg 47m-148mg, including 40 males and 10 females. All the patients were diagnosed by overnight sleep monitoring after admission. The average age was 77.13 m ~ (36 m ~ (-1) m ~ (-1) m ~ (-1)), 33 male and 19 female. The group was a physical examination child with no related diseases and systemic diseases. The peripheral venous blood was collected after admission. The analysis was performed by Becton Dickinson (BDD) FACSCalibur flow cytometry and BN- 鈪，

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