本文選題：阻塞性睡眠呼吸暫停低通氣綜合征　切入點：兒童　出處：《山西醫(yī)科大學》2010年碩士論文

【摘要】： 目的： 了解阻塞性睡眠呼吸暫停低通氣綜合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患兒血清心肌酶譜水平的變化,判定兒童OSAHS對心肌損害的影響；研究OSAHS術(shù)前及術(shù)后血清心肌酶譜的變化、確定手術(shù)對治療兒童OSAHS的作用,為兒童OSAHS并發(fā)癥的預防及保護性治療提供一定的理論依據(jù)。 方法： 1.收集兒童OSAHS患者90例,輕、中、重度各30例,其中OSAHS中重度患兒入院行腺樣體和／或扁桃體切除,術(shù)后一月隨訪患兒60例,兒�？企w檢正常兒童30例作為對照組,OSAHS患兒均行多導睡眠監(jiān)測(polysomnogruphy,PSG)。 2.采集上述病例空腹血清,以全自動生化分析儀檢測并比較各組間心肌酶譜水平。 3.運用統(tǒng)計學方法分析OSAHS患兒血清心肌酶譜與睡眠期呼吸暫停低通氣指數(shù)(apnea hypopnea index,AHI)和最低血氧飽和度(lowest oxygen saturations,LSaO2)之間的關(guān)系及其相關(guān)性。 結(jié)果： 1.PSG結(jié)果：OSAHS中重度組兒童,術(shù)后AHI及LSaO2與術(shù)前比較,差異均有統(tǒng)計學意義(分別為P0.05,P0.05)。 2.輕中重度組OSAHS患兒心肌酶譜水平較正常對照組明顯升高,差異有統(tǒng)計學意義(P0.05)。 3.中重度組OSAHS患兒術(shù)后一月較術(shù)前心肌酶譜水平明顯降低,差異有統(tǒng)計學意義(P0.05)；中重度組OSAHS術(shù)后較正常對照組心肌酶譜水平無顯著變化,差異無統(tǒng)計學意義(P0.05)。 4.兒童OSAHS患者血清心肌酶譜隨AHI的增加及缺氧程度的加重而增高,并與AHI正相關(guān)(P0.05；)。與LSaO2負相關(guān)(P0.05)。 結(jié)論： 1.OSAHS患兒睡眠時反復發(fā)作低氧血癥和酸中毒可能是心肌受損的一個原因。 2.隨著OSAHS患兒缺氧程度增加,心肌損傷情況可能越重。 3.手術(shù)解除阻塞可作為治療兒童OSAHS的有效辦法。
[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.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R766

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