白细胞介素-6、白细胞介素-10及血管黏附因子-1在儿童阻塞性睡眠呼吸暂停-低通气综合征中的变化及意义  

Changes and significances of interleukin-6, interleukin-10 and vascular adhesion molecule-1 in children with obstructive sleep apnea-hypopnea syndrome

作　　者：阿布来提·阿不都哈尔[1] 布力布丽·巴哈提[1] 徐佩茹 

机构地区：[1]新疆医科大学第一附属医院儿科,乌鲁木齐830054 [2]新疆维吾尔自治区循证医学研究所

出　　处：《中华实用儿科临床杂志》2014年第4期274-278,共5页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的 探讨阻塞性睡眠呼吸暂停-低通气综合征（OSAHS）患儿血清因子IL-6、抗炎因子IL-10及血管黏附因子-1（ICAM-1）水平变化的意义.方法 因睡眠打鼾就诊的门诊及住院患儿142例,以多导睡眠监测仪检测结果作为金标准,将患儿分为OSAHS组（47例）和对照组（95例）.采用酶联免疫吸附法测定并比较各组间IL-6、IL-10,高敏C-反应蛋白（hsCRP）及ICAM-1水平的差异,并将OSAHS组IL-6、IL-10及ICAM-1水平与各睡眠呼吸参数进行相关分析.将OSAHS组患儿按呼吸暂停低通气指数（AHI）水平分轻、中、重3组,对3组间以上指标的差异进行统计学分析.确诊为OSAHS的患儿治疗后12周再次进行评估.结果 OSAHS组血清IL-6、ICAM-1及hsCRP水平[（2.98 ±0.27） ng/L、（391.7±115.6） μg/L、（15.4±4.9） mg/L]均高于对照组[（1.67±0.07） ng/L、（189.8±106.4） μg/L、（12.5±2.1）mg/L],而血清IL-10水平[（195.2±33.6）ng/L]低于对照组[（458.5±102.2） ng/L],差异均有统计学意义（t=33.26、32.45、10.94、-53.72,P均＜0.01）.OSAHS患儿轻、中、重3组,IL-6、IL-10及ICAM-1水平比较差异均有统计学意义（F=128.90、102.60、8.25,P均＜0.05）,其中,重度组血清IL-6、ICAM-1及hsCRP[（3.22±0.27） ng/L、（427.7±95.4） μg/L、（21.0±3.9）mg/L]均高于轻度组[（1.92±0.24） ng/L、（236.5±115.6） μg/L、（11.0±3.8） mg/L]及中度组[（2.02±0.31）ng/L、（401.5±105.6） μg/L、（17.0 ±2.8） mg/L],且随AHI的增加,血清IL-6、ICAM-I及hsCRP也升高.而重度组血清IL-10水平[（115.2±30.6） ng/L]低于轻度组及中度组[（400.2±55.6） ng/L、（203.2±27.6）ng/L].OSAHS患儿血清IL-6及ICAM-1水平与AHI及微觉醒指数均呈正相关（r=0.341、0.427,P均＜0.05）,与夜间最低血氧饱和度（LSaO2）呈负相关（r=-0.190,P＜0.01）,而与体质量指数（BMI）无相关性（r=-0.121,P＞0.05）,血清IL-10水平与AHI呈负相关（r=-0.266,P ＜0.05）,与LSaO2呈正�Objective To discuss the variation in serum factor IL-6,anti-inflammatory cytokine IL-10,and vascular cell adhesion molecule-1 （ICAM-1） level of children with obstructive sleep apnea-hypopnea syndrome （OSAHS） and their clinical significances.Methods One hundred and forty-two hospitalized children were divided into 2 groups：OSAHS group （47 cases） and the control group （95 cases）,according to test result of polysomnography （the golden standard）.The differences of IL-6,IL-10,high-sensitivity C-reactive protein （hsCRP） and ICAM-1 level between the two groups were measured and compared by using enzyme linked immunosorbent assay,and correlation analysis between IL-6,IL-10,ICAM-1 and each sleep-breathing parameter of OSAHS group was performed.The children of OSAHS group were divided into 3 groups：mild,moderate and severe group,according to the level of apnea hypopnea index（AHI）.Statistical analysis was performed on the above indexes among the 3 groups.Reassessment of the children diagnosed with OSAHS was performed after 12 weeks of treatment.Results The serum levels of IL-6,ICAM-1 and hsCRP [（2.98 ± 0.27） ng/L,（391.7 ± 115.6） μg/L,（15.4 ± 4.9） mg/L] of OSAHS group were significantly higher than those of the control group[（1.67 ± 0.07） rng/L,（189.8 ± 106.4） μg/L,（2.5 ± 2.1） mg/L],while its serum IL-10 level was lower than that of the control group[（195.2 ± 33.6） ng/L vs （458.5 ± 102.2）ng/L],and there were significant differences between the 2 groups （t =33.26,32.45,10.94,-53.72,all P ＜0.01） ; there were significant differences in terms of IL-6,IL-10 and ICAM-1 level among the mild,the moderate and the severe groups （F =128.90,102.60,8.25,all P ＜0.05）.Of which the serum levels of IL-6,ICAM-1 and hsCRP of the severe group[（3.22 0.27） ng/L,（427.7 ± 95.4） μg/L,（21.0 ± 3.9） mg/L] were higher than those of the mild group [（1.92 ± 0.24） ng/L,（236.5 ± 115.6） μg/L,（11.0 ± 3.8） mg/L] and the moderate group [（2.02

关 键 词：睡眠呼吸暂停 阻塞性 白细胞介素-6 白细胞介素-10 血管黏附因子-1 儿童 

分 类 号：R766[医药卫生—耳鼻咽喉科]