血浆儿茶酚胺水平联合脑电图在儿童睡眠障碍评估中的应用价值分析  

Application value of plasma catecholamine level combined with EEG in the evaluation of sleep disorders in children

作　　者：陈洁鸿 肖贞 吴卫照 CHEN Jiehong;XIAO Zhen;WU Weizhao(Department of Pediatrics,Xiaolan Hospital Affiliated to Southern Medical University,Guangdong 528415,China)

机构地区：[1]南方医科大学附属小榄医院儿科,广东中山528415

出　　处：《中国优生与遗传杂志》2022年第11期1943-1947,共5页Chinese Journal of Birth Health & Heredity

摘　　要：目的 探讨血浆儿茶酚胺(CA)水平联合脑电图在儿童睡眠障碍评估中的应用价值。方法 选择2017年8月至2021年12月南方医科大学附属小榄医院儿科收治的80例睡眠障碍患儿为研究对象,另选取80例健康儿童作为对照。收集纳入对象临床资料,观察并对比两组血浆CA水平及脑电图参数差异,利用受试者操作特征(ROC)曲线分析CA及脑电图参数对儿童睡眠障碍的诊断价值。采用LASSO及Logistic回归探讨影响儿童睡眠的相关因素,并采用R语言构建列线图预测模型。结果 与无睡眠障碍组儿童比较,睡眠障碍组患儿肾上腺素(E)、多巴胺(DA)、去甲肾上腺素水平(NE)均显著增加(P<0.05);睡眠总时间、S1期、S2期、S3期、S4期、REM及睡眠效率显著降低(P<0.05),而睡眠潜伏期、觉醒时间、觉醒次数则显著增加(P<0.05)。CA、脑电图均对儿童睡眠障碍具有一定的诊断价值(AUC>0.7),且二者联合诊断价值更高。NE、E、DA、睡眠潜伏期、觉醒时间、觉醒次数为儿童发生睡眠障碍的独立危险因素,S3期为保护因素,基于以上因素构建的列线图预测模型具有良好的准确性和临床有效性。结论 血浆CA及脑电图参数对儿童睡眠障碍均具有较高的诊断价值,且二者联合的诊断价值更高,NE、E、DA、睡眠潜伏期、觉醒时间、觉醒次数及S3期均与儿童睡眠障碍有关。Objective To investigate the value of catecholamine(CA) level combined with EEG in the evaluation of sleep disorders in children. Methods 80 children with sleep disorders admitted to the pediatric department of Xiaolan Hospital Affiliated to Southern Medical University from August 2017 to December 2021 were selected as the research objects, and another 80 healthy children were selected as control, the clinical data of included subjects were collected, and the differences of plasma CA level and EEG parameters between the two groups were observed and compared, the diagnostic value of CA and EEG parameters in children with sleep disorders were analyzed by receiver operating characteristic(ROC) curve. The LASSO and Logistic regression were performed to explore the related factors affecting children’s sleep, and R language was carried out to construct nomogram prediction model. Results Compared with the children without sleep disorder, the levels of epinephrine(E), dopamine(DA) and norepinephrine(NE) in children with sleep disorder were significantly increased(P<0.05),while the total sleep time, S1 phase, S2 phase, S3 phase, S4 phase, REM and sleep efficiency decreased remarkably(P<0.05),and the sleep latency, wake-up time and wake-up times increased evidently(P<0.05). Both CA and EEG have certain diagnostic value for children with sleep disorder(AUC>0.7), and the combined diagnosis value of them was higher. The plasma NE, E,DA and sleep latency, wake-up time, wake-up times were independent risk factors for sleep disorders in children, while the S3phase is protective factor, the nomogram prediction model based on above factors has great accuracy and clinical effectiveness.Conclusion Plasma CA and EEG parameters have high diagnostic value for children’s sleep disorders, and their combination has higher diagnostic value. The plasma NE, E, DA and sleep latency,wake-up time, wake-up times, S3 phase are related to children’s sleep disorders.

关 键 词：睡眠障碍 儿茶酚胺 脑电图 预测模型 

分 类 号：R179[医药卫生—妇幼卫生保健]