阻塞性睡眠呼吸暂停低通气综合征儿童认知功能损害与25(OH)D_(3)水平的关系  

The relationship between cognitive function impairment and 25(OH)D3 levels in children with obstructive sleep apnea-hypopnea syndrome

作　　者：蔡伟妮 俞晨艺[1] 钟佩佩[3] 蔡晓红[1] CAI Weini;YU Chenyi;ZHONG Peipei;CAI Xiaohong(Department of Pediatric Sleep Medicine,the Second Affiliated Hospital&Yuying Children’s Hospital of Wenzhou Medical University,Wenzhou 325027,China;Department of Pediatrics,Taizhou Central Hospital(Taizhou University Hospital),Taizhou 318000,China;Department of Pediatric Infectious Diseases,the Second Affiliated Hospital&Yuying Children’s Hospital of Wenzhou Medical University,Wenzhou 325027,China)

机构地区：[1]温州医科大学附属第二医院育英儿童医院儿童睡眠医学科,浙江温州325027 [2]台州市中心医院(台州学院附属医院)小儿内科,浙江台州318000 [3]温州医科大学附属第二医院育英儿童医院儿童感染科,浙江温州325027

出　　处：《温州医科大学学报》2024年第8期664-669,共6页Journal of Wenzhou Medical University

基　　金：浙江省医药卫生科技计划项目(2019ZD013)。

摘　　要：目的:分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)儿童认知功能与25羟维生素D_(3)[25(OH)D_(3)]水平的关系,探讨OSAHS儿童认知功能损害的机制。方法:选取2022年1月至2023年1月温州医科大学附属第二医院育英儿童医院儿童睡眠医学科因“鼾症”收治住院的儿童100例,根据整夜多导睡眠监测结果,诊断为OSAHS组50例、单纯鼾症组50例,并选取同期在我院体检的健康儿童30例作为健康组。比较健康组、单纯鼾症组、OSAHS组儿童的睡眠监测数据、认知功能、血清25(OH)D_(3)水平。结果:与健康组、单纯鼾症组儿童比较,OSAHS患儿睡眠效率(SE)下降、深睡眠时间(SWM期睡眠)减少,浅睡眠(Ⅰ期+Ⅱ期睡眠)时间增多(P<0.05),最低氧饱和度(L-SpO_(2))、阻塞性呼吸暂停低通气指数(OAHI)在3组间差异均有统计学意义(P<0.05)。OSAHS患儿血清25(OH)D_(3)水平明显下降(P<0.05)。OSAHS组患儿计划水平、注意力水平下降(P<0.05),同时性加工、继时性加工水平3组间差异无统计学意义(P>0.05)。Pearson相关性分析显示,OASHA患儿血清25(OH)D_(3)水平与L-SpO_(2)呈正相关(r=0.793,P<0.001),与OAHI呈负相关(r=-0.559,P<0.001),25(OH)D_(3)水平与计划水平呈正相关(r=0.615,P<0.001),与注意力水平亦呈正相关(r=0.558,P<0.001)。OSAHS儿童OAHI与计划水平呈负相关(r=-0.630,P<0.001),与注意力水平亦呈负相关(r=-0.538,P<0.001);OSAHS儿童L-SpO_(2)与计划水平呈正相关(r=0.841,P<0.001),与注意力水平亦呈正相关(r=0.477,P<0.001)。结论:儿童血清25(OH)D_(3)水平与OSAHS患病存在一定关联,OSAHS的严重程度与25(OH)D_(3)水平呈负相关,OSAHS儿童认知功能损害与25(OH)D_(3)水平呈正相关,OSAHS的严重程度与认知功能损害呈正相关,血清25(OH)D_(3)水平下降可能加剧OSAHS儿童认知功能损害。Objective:To analyze the relationship between cognitive function and 25-hydroxyvitamin D_(3)[25(OH)D_(3)]levels in children with obstructive sleep apnea-hypopnea syndrome(OSAHS)and explore the mechanism of cognitive function impairment in children with OSAHS.Methods:From January 2022 to January 2023,100 children admitted to the Department of Pediatric Sleep Medicine of the Second Affiliated Hospital&Yuying Children’s Hospital of Wenzhou Medical University due to“snoring”were selected.According to the results of overnight polysomnography monitoring,50 children in the OSAHS group and 50 children in the simple snoring group.And 30 healthy children who underwent physical examinations in the same period were selected as healthy group.The sleep monitoring data,cognitive function,and serum 25(OH)D_(3)levels of children in the healthy group,simple snoring group,and OSAHS group were compared.Results:Compared with the healthy group and the simple snoring group,children with OSAHS had decreased sleep effficiency(SE),reduced deep sleep time(SWM sleep),increased light sleep time(Ⅰ+Ⅱ sleep),statistically significant differences in minimum oxygen saturation(L-SpO_(2))and obstructive apnea hypopnea index(OAHI)among the three groups(P<0.05).The serum 25(OH)D_(3)levels in children with OSAHS were decreased significantly(P<0.05).The planned level and attention level of children in OSAHS group decreased(P<0.05),with no statistically significant differences in simultaneous processing and sequential processing levels among the three groups(P>0.05).Pearson correlation analysis showed that the serum 25(OH)D_(3)levels of OSAHS children were positively correlated with L-SpO_(2)(r=0.793,P<0.001),and negatively correlated with OAHI(r=-0.559,P<0.001).25(OH)D_(3)level was positively correlated with the planning level(r=0.615,P<0.001)and attention level(r=0.558,P<0.001).The OAHI in OSAHS children was negatively correlated with the planned level(r=-0.630,P<0.001)and attention level(r=-0.538,P<0.001).L-SpO_(2)of children with OSAHS was

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 25(OH)D_(3) 认知功能 儿童 

分 类 号：R725.6[医药卫生—儿科]