儿童阻塞性睡眠呼吸暂停低通气综合症心肌酶谱检测的临床分析及意义

发布时间：2018-04-03 17:15

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：《山西医科大学》2010年硕士论文

【摘要】： 目的：了解阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患儿血清心肌酶谱水平的变化,判定儿童OSAHS对心肌损害的影响；研究OSAHS术前及术后血清心肌酶谱的变化、确定手术对治疗儿童OSAHS的作用,为儿童OSAHS并发症的预防及保护性治疗提供一定的理论依据。方法： 1.收集儿童OSAHS患者90例,轻、中、重度各30例,其中OSAHS中重度患儿入院行腺样体和／或扁桃体切除,术后一月随访患儿60例,儿保科体检正常儿童30例作为对照组,OSAHS患儿均行多导睡眠监测(polysomnogruphy,PSG)。 2.采集上述病例空腹血清,以全自动生化分析仪检测并比较各组间心肌酶谱水平。 3.运用统计学方法分析OSAHS患儿血清心肌酶谱与睡眠期呼吸暂停低通气指数(apnea hypopnea index,AHI)和最低血氧饱和度(lowest oxygen saturations,LSaO2)之间的关系及其相关性。结果： 1.PSG结果：OSAHS中重度组儿童,术后AHI及LSaO2与术前比较,差异均有统计学意义(分别为P0.05,P0.05)。 2.轻中重度组OSAHS患儿心肌酶谱水平较正常对照组明显升高,差异有统计学意义(P0.05)。 3.中重度组OSAHS患儿术后一月较术前心肌酶谱水平明显降低,差异有统计学意义(P0.05)；中重度组OSAHS术后较正常对照组心肌酶谱水平无显著变化,差异无统计学意义(P0.05)。 4.儿童OSAHS患者血清心肌酶谱随AHI的增加及缺氧程度的加重而增高,并与AHI正相关(P0.05；)。与LSaO2负相关(P0.05)。结论： 1.OSAHS患儿睡眠时反复发作低氧血症和酸中毒可能是心肌受损的一个原因。 2.随着OSAHS患儿缺氧程度增加,心肌损伤情况可能越重。 3.手术解除阻塞可作为治疗儿童OSAHS的有效办法。
[Abstract]:Objective:To investigate the changes of serum myocardial enzyme spectrum in children with obstructive sleep apnea hypopnea syndrome (OSAHS), to determine the effect of OSAHS on myocardial damage in children, to study the changes of serum myocardial enzymes before and after OSAHS, and to study the changes of serum myocardial enzymes in children with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after OSAHS.To determine the effect of operation on the treatment of OSAHS in children, and to provide a theoretical basis for the prevention and protective treatment of complications of OSAHS in children.Methods:1.90 cases of children with OSAHS were collected, including 30 cases of mild, moderate and severe OSAHS. Among them, 30 cases of moderate and severe OSAHS were admitted to hospital for adenoidectomy and / or tonsillectomy, and 60 cases were followed up one month after operation.30 normal children as the control group were treated with polysomnogrugous polysomnoporus (PSGG) with polysomnogrul sleep (polysomnogrusia).2.The fasting serum was collected and the myocardial enzyme levels were measured by automatic biochemical analyzer.3.The relationship between serum myocardial enzyme spectrum and apnea hypopnea index (AHIH) and lowest oxygen saturation (LSaO2) in children with OSAHS were analyzed by statistical method.Results:Results there were significant differences in AHI and LSaO2 between the children in the moderate and severe group of 1.PSG and those before operation (P0.05, P0.05, P0.05, respectively).2.The level of myocardial enzyme spectrum in mild, moderate and severe OSAHS group was significantly higher than that in normal control group (P 0.05).3.The level of myocardial enzyme spectrum in moderate and severe OSAHS group was significantly lower than that in preoperative group one month after operation, the difference was statistically significant (P 0.05), and the level of myocardial enzyme spectrum in moderate and severe OSAHS group was not significantly different from that in normal control group (P 0.05).4.The serum myocardial enzyme spectrum in children with OSAHS increased with the increase of AHI and the degree of hypoxia, and was positively correlated with AHI (P 0.05).There was a negative correlation with LSaO2 (P 0.05).Conclusion:Recurrent hypoxemia and acidosis during sleep in children with 1.OSAHS may be a cause of myocardial damage.2.As the degree of hypoxia increases in children with OSAHS, myocardial injury may become more severe.3.Surgical removal of obstruction may be an effective method for the treatment of OSAHS in children.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R766

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