本文選題：阻塞性睡眠呼吸暫停低通氣綜合征　切入點(diǎn)：兒童　出處：《浙江大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：背景及目的： 阻塞性睡眠呼吸暫停低通氣綜合征(Obstructive Sleep Apnea-hypopnea Syndrome, OSAHS)是以睡眠間斷性上氣道部分或完全梗阻為特點(diǎn)的睡眠呼吸紊亂,可以發(fā)生在從新生兒到青春期的各個年齡階段,總體發(fā)病率為1-4%。OSAHS患兒由于呼吸氣流改變、夜間反復(fù)發(fā)生低氧血癥、二氧化碳潴留及反復(fù)覺醒等原因引起患兒多系統(tǒng)的損害,造成患幾生長發(fā)育落后、心臟功能改變、傳導(dǎo)性耳聾、顏面發(fā)育畸形、記憶力減退、智力下降及性格改變等多種嚴(yán)重并發(fā)癥。兒童OSAHS在2-6歲出現(xiàn)發(fā)病的高峰,這與腺樣體及扁桃體生理性肥大密切相關(guān)。關(guān)于阻塞性睡眠呼吸暫停低通氣綜合征對兒童免疫系統(tǒng)功能影響的研究國內(nèi)尚不多,且多局限于體液免疫或者細(xì)胞免疫中的一種。本研究擬通過采集外周靜脈血進(jìn)行T細(xì)胞亞群、免疫球蛋白、補(bǔ)體及細(xì)胞因子分析的方法,探討OSAHS對患兒體液免疫及細(xì)胞免疫的影響。 資料與方-法： 選擇2010年5月至2011年8月,50例在我科住院的OSAHS患兒。該組患幾平均年齡79.38m(47m-148m),其中男40例,女10例。所有患兒均在入院后通過整夜睡眠監(jiān)測確診。正常對照組52例,年齡平均77.13m(36m-143m),男33例,女19例。該組為無相關(guān)性疾病及全身性疾病的體檢兒童。入院后采集外周靜脈血,分析采用美國Becton Dickinson (BD) FACSCalibur流式細(xì)胞儀及西門子公司BN Ⅱ免疫分析儀。檢測指標(biāo)包括：CD3+, CD4+, CD8+, IgA, IgG, IgM, IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ. 結(jié)果： OSAHS組,CD8+T淋巴細(xì)胞所占百分比明顯高于對照組(26.47±5.52vs.23.974±4.92),差異有顯著意義(P=0.017)。CD4+/CD8+比值明顯低于對照組(1.24±0.38vs.1.45±0.41),有顯著差異(P=0.006)。OSAHS組,患兒血清IgA含量明顯高于對照組(1.63±1.01g/L vs.1.07±±0.48g/L),有顯著差異(P=0.000)。OSAHS組患兒血清C3含量明顯高于對照組(1.17±0.23g/L vs.1.03±0.15g/L),有顯著差異(P=0.001)。OSAHS組,患兒血清IL-4含量明顯高于對照組[2.45(0.60、7.90)pg/mL vs.1.25(0.60、4.80) pg/mL],有顯著差異(P=0.000)。OSAHS組患兒血清IL-6含量明顯高于對照組[3.75(1.50、36.50)pg/mL vs.2.50(1.20、37.90)pg/mL],有顯著差異(P=0.009). OSAHS組患兒血清IL-10含量明顯高于對照組[3.45(1.80、16.40) pg/mL vs.3.10(1.50、6.30) pg/mL],有顯著差異(P=0.001)。OSAHS組患兒血清IFN-y含量明顯高于對照組[4.40(1.00、16.60)pg/mL vs.2.65(1.00、24.50) pg/mL],有顯著差異(P=0.003)。 結(jié)論： OSAHS患兒CD8+T淋巴細(xì)胞所占百分比上升,CD4+/CD8+比值降低,存在細(xì)胞免疫功能低下,體液免疫指標(biāo)IL-4, IL-6, IL-10, IFN-γ上升,提示機(jī)體處于氧化應(yīng)激和全身炎癥狀態(tài)。
[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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