【摘要】 目的:分析儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者手术前后血尿酸(UA)的变化,探讨血尿酸在儿童OSAHS的诊断与治疗中的临床价值。方法:98例患儿经多导睡眠监测(PSG)确诊,具备腺样体和(或)扁桃体切除手术指征,根据睡眠呼吸暂停低通气指数(AHI)分为3组:轻度组32例(5≤AHI<10),中度组41例(10≤AHI<20),重度组25例(AHI≥20),各组于术前及术后6个月清晨抽取肘静脉血液标本测定血UA水平,另选择健康儿童体检者35例作为对照组。结果:术前各组AHI、最低血氧饱和度(LSaO2)与健康对照组之间的差异均有统计学意义(P<0.05);轻度组术前UA与健康对照组之间的差异无统计学意义(P>0.05),中、重度组术前UA显著增高,与健康对照组及轻度组之间的差异有统计学意义(P<0.05)。术后各组AHI、LSaO2、UA与健康对照组相比,差异均无统计学意义(P>0.05);与术前相比,除轻度组UA外,差异均有统计学意义(P<0.05)。UA水平与AHI呈正相关(r=0.25,P<0.05),与LSaO2呈负相关(r=-0.42,P<0.05)。结论:中重度儿童OSAHS患者UA水平显著增高,手术治疗后UA降至健康儿童水平,因此UA可作为儿童OSAHS诊断与治疗的临床参考指标。更多还原

【Abstract】 Objective:To analyze the changes of blood uric acid(UA)before and after operation and to investigate clinical value of UA in children with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods:A total of 98children with OSAHS diagnosed by polysomnography(PSG)had indications of adenotonsillectomy.According to apnea hypopnea index(AHI),all cases were divided into three groups as:mild group(5≤AHI<10,n=32),moderate group(10≤AHI<20,n =41),and severe group(AHI≥20,n=25).The levels of blood UA were determined before and 6months after operation.Thirty-five normal children for physical examination were served as control group.Results:There were statistical significances in AHI and lowest arterial oxygen saturation(LSaO2)between each preoperative group and control group(P<0.05).The difference of UA was not statistically significant between mild group before operation and control group(P> 0.05),but it was significant between moderate/severe group and mild/control group(P<0.05).There were no statistical significances in AHI,LSaO2,and UA between each postoperative group and control group(P>0.05).Except for UA of mild group(P>0.05),AHI,LSaO2 and UA changed significantly after operation(P<0.05).The level of UA had a positive correlation with AHI(r=0.25,P<0.05)and a negative correlation with LSaO2(r=-0.42,P<0.05).Conclusion:The level of UA increases significantly in children with moderate and severe OSAHS,and decreases to normal after adenotonsillectomy.UA can be used as a clinical marker in diagnosis and treatment of children with OSAHS.更多还原