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目的:分析阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患儿龋齿的发生率及不同程度OSAHS患儿血清食欲素A浓度。方法:经多导睡眠监测确诊的167例OSAHS患儿为病例组,90例体检健康儿童为对照组。经口腔专科检查评估有无龋齿,比较两组的龋齿发生率;按呼吸暂停低通气指数(AHI)和最低血氧饱和度(LSaO_2)将OSAHS患儿分为轻度组(5次/h≤AHI<10次/h,0.85≤LSa O2<0.91,n=89),中度组(10次/h≤AHI<20次/h,0.75≤LSaO_2≤0.84,n=71),重度组(AHI≥20次/h,LSa O2<0.75,n=7),比较3组OSAHS患儿龋齿的发生率;采用竞争酶联免疫分析(EIA)法测定3组OSAHS患儿血清食欲素A浓度,对OSAHS患儿病情轻重程度与血清食欲素A浓度进行相关性分析。结果:OSAHS组患儿龋齿发生率为64.67%(108/167),明显高于对照组[51.11%(46/90),χ~2=3.930 6,P<0.05]。轻度、中度以及重度OSAHS患儿龋齿发生率分别为67.42%(60/89)、66.20%(47/71)、14.29%(1/7),3组间差异有统计学意义(χ~2=8.144,P<0.05);轻、中和重度OSAHS患儿血清食欲素A浓度分别为(0.27±0.04),(0.41±0.07),(0.52±0.06)μg/m L,差异有统计学意义(F=114.22,P<0.01)。Spearman相关分析显示,OSAHS睡眠障碍程度与血清食欲素A浓度存在正相关。结论:OSAHS患儿龋齿的发生率明显增加,睡眠障碍程度与血清食欲素A浓度存在正相关。
Objective: To analyze the incidence of dental caries in children with obstructive sleep apnea hypopnea syndrome (OSAHS) and the levels of serum orexin A in OSAHS children. Methods: 167 children with OSAHS diagnosed by polysomnography were selected as case group and 90 healthy children as control group. The dental caries were evaluated by dental examination to compare the incidence of dental caries in the two groups. According to the apnea-hypopnea index (AHI) and the lowest oxygen saturation (LSaO_2), the OSAHS children were divided into mild group (5 times / h≤ AHI <10 / h, 0.85≤LSa O2 <0.91, n = 89), moderate group (10 times / h≤AHI≤20 times / h, 0.75≤LSaO_2≤0.84, n = 71) The incidence of dental caries in 3 OSAHS children was compared between the two groups. The levels of serum orexin A in 3 OSAHS children were determined by competitive enzyme-linked immunosorbent assay (EIA) The severity of OSAHS children with serum orexin A concentration correlation analysis. Results: The incidence of dental caries was 64.67% (108/167) in OSAHS group, which was significantly higher than that in control group [51.11% (46/90), χ ~ 2 = 3.9306, P <0.05]. The incidence of dental caries in children with mild, moderate and severe OSAHS were 67.42% (60/89), 66.20% (47/71) and 14.29% (1/7), respectively. There was significant difference between the three groups (χ ~ 2 = 8.144, P <0.05). The levels of serum orexin A in children with mild, moderate and severe OSAHS were (0.27 ± 0.04), (0.41 ± 0.07) and (0.52 ± 0.06) μg / Significance (F = 114.22, P <0.01). Spearman correlation analysis showed that there was a positive correlation between OSAHS sleep disorder and serum orexin-A concentration. Conclusion: The incidence of dental caries in children with OSAHS is significantly increased, and the degree of sleep disorders is positively correlated with serum orexin A concentration.