本文選題：睡眠呼吸暫停低通氣綜合征 + 阻塞性　； 參考：《山東大學(xué)》2014年碩士論文

【摘要】：研究目的： 通過研究兒童阻塞性睡眠呼吸暫停低通氣綜合征(Obstructive Sleep Apnea-hypopnea Syndrome, OSAHS)認(rèn)知行為異常與血清BDNF的關(guān)系,闡釋兒童OSAHS認(rèn)知行為異常可能的發(fā)病機(jī)制。 研究方法： 1.選擇2012年3月至2013年11月期間因睡眠時(shí)打鼾于齊魯醫(yī)院耳鼻咽喉科住院治療的4-12歲兒童62例,經(jīng)整夜多導(dǎo)睡眠儀(Polysomnography, PSG)監(jiān)測,診斷為OSAHS40例,單純鼾癥22例,同時(shí)從小兒外科選取22例無睡眠時(shí)打鼾,并排除其他神經(jīng)系統(tǒng)疾病的健康兒童做為健康對照組。 2.采用Conners兒童簡明癥狀問卷評估各組兒童行為問題,問卷由各個(gè)研究對象的父母填寫,問卷總分為30分,評定總和大于等于10分為認(rèn)知行為異常。 3.對各組兒童行整夜PSG監(jiān)測,采集并記錄各項(xiàng)監(jiān)測數(shù)據(jù),主要監(jiān)測指標(biāo)有呼吸暫停低通氣指數(shù)(AHI)、微覺醒指數(shù)(AI)、最低血氧飽和度(LSaO2)總睡眠時(shí)間(TST)、慢波睡眠(SWS)及REM期睡眠占總睡眠時(shí)間的比例等。 4.清晨6：30-7：00am取研究對象的空腹肘靜脈血于抗凝管中,離心后收取血清后-80℃冰箱中保存,應(yīng)用酶聯(lián)免疫吸附法(ELISA)檢測各組兒童血清中BDNF的濃度。研究結(jié)果： 1.OSAHS組及單純鼾癥組存在行為問題的比率高于健康對照組(P0.01),而兩組之間無統(tǒng)計(jì)學(xué)差異(P0.05)。 2. OSAHS組存在行為異常的兒童REM睡眠占總睡眠時(shí)間比例(%TST)與不存在行為異常的兒童相比減少(P0.05),AI、最低血氧飽和度也有明顯差異(P0.05),而AHI、SWS (%TST)無統(tǒng)計(jì)學(xué)差異(P0.05)。單純鼾癥組存在行為異常的兒童的AI高于不存在行為異常的兒童,而AHI、最低血氧飽和度、SWS(%TST)及REM(%TST)無統(tǒng)計(jì)學(xué)差異。 3.OSAHS組、單純鼾癥組BDNF水平低于健康對照組(P0.01),而兩組之間無統(tǒng)計(jì)學(xué)差異(P0.1)。OSAHS組伴有行為異常者BDNF水平低于不伴有行為異常者(P0.01)；單純鼾癥組伴有行為異常者BDNF水平低于不伴有行為異常者(P0.05)。 結(jié)論： 1. OSAHS及單純鼾癥兒童較健康兒童有較高的認(rèn)知行為異常發(fā)生率。 2.睡眠結(jié)構(gòu)紊亂尤其是REM睡眠的減少、頻繁覺醒以及夜間嚴(yán)重的血氧飽和度下降可能是OSAHSL童認(rèn)知行為異常的重要原因。 3.血清BDNF水平的改變與OSAHS及單純鼾癥兒童的認(rèn)知行為異常存在一定相關(guān)性,BDNF可能在包括OSAHS與單純鼾癥的SDB兒童認(rèn)知行為異常的發(fā)生發(fā)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，

本文編號：2104715