全麻下扁桃体切除术对OSAHS患儿发音特征及血液中PCT、GMP-140、T淋巴细胞亚群的影响  

Effects of tonsillectomy under general anaesthesia on articulatory characteristics and blood levels of PCT,GMP-140,and T lymphocyte subsets in children with obstructive sleep apnea-hypopnea syndrome

作　　者：王子寒 潘红帅 WANG Zihan;PAN Hongshuai(Department of Otolaryngology Head and Neck Surgery,Xi′an Children’s Hospital,Xi′an 710038,China)

机构地区：[1]西安市儿童医院耳鼻咽喉头颈外科,陕西西安710038 [2]西北大学第一附属医院耳鼻咽喉头颈外科

出　　处：《精准医学杂志》2024年第6期519-522,526,共5页Journal of Precision Medicine

摘　　要：目的探讨全麻下扁桃体切除术对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患儿发音特征及血液中降钙素原(PCT)、血小板膜蛋白-140(GMP-140)、T淋巴细胞亚群等的影响。方法随机选取2020年6月—2022年3月在西安市儿童医院耳鼻咽喉头颈外科行全麻下扁桃体切除术的OSAHS患儿43例。分别于术前及术后第1、3个月时检测患儿发音特征及血清中PCT、GMP-140、T淋巴细胞亚群的水平,同时检测患儿的睡眠情况。结果与术前比较,术后第1、3个月患儿发/a/时最长发音时间明显延长,第二共振峰明显增强(F=43.07、39.65,P<0.05);与术前比较,术后第1、3个月患儿发/i/时最长发音时间明显延长,第四共振峰明显增强(F=21.43、44.25,P<0.05)。与术前比较,术后第1、3个月患儿血液中PCT、GMP-140、CD8^(+)水平及呼吸暂停低通气指数明显降低(F=29.67~112.86,P<0.05),血液中CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平及夜间最低血氧饱和度水平、魁北克睡眠问卷评分明显升高(F=12.15~234.11,P<0.05)。结论全麻下扁桃体切除术能够使OSAHS患儿发/a/、/i/时最长发音时间明显延长,发音特征明显改善,同时可降低患儿炎症反应,改善睡眠质量,并对恢复免疫功能有积极作用。Objective To explore the effects of tonsillectomy under general anesthesia on articulatory characteristics and blood levels of procalcitonin(PCT),platelet membrane protein-140(GMP-140),and T lymphocyte subsets in children with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods Forty-three children with OSAHS who underwent tonsillectomy under general anesthesia in the Department of Otorhinolaryngology Head and Neck Surgery of Xi’an Children’s Hospital,Shaanxi Province from June 2020 to March 2022 were randomly selected for the study.The children were evaluated for articulatory characteristics,blood levels of PCT,GMP-140,and T lymphocyte subsets,as well as sleep status before surgery and at 1 and 3 months after surgery.Results The longest duration of articulating/a/was significantly prolonged and the second formant was significantly enhanced at 1 and 3 months after surgery(F=43.07,39.65,P<0.05).The longest duration of articulating/i/was significantly prolonged and the fourth formant was significantly enhanced at 1 and 3 months after surgery(F=21.43,44.25,P<0.05).At 1 and 3 months after surgery,the blood levels of PCT,GMP-140,and CD8^(+)and apnea hypoventilation index were significantly reduced(F=29.67-112.86,P<0.05);the blood levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+),nocturnal lowest blood oxygen saturation,and Quebec Sleep Questionnaire scores were significantly increased(F=12.15-234.11,P<0.05).Conclusion Tonsillectomy under general anesthesia can significantly prolong the longest duration of articulating/a/and/i/in children with OSAHS,improve their articulatory characteristics,reduce the inflammatory response,improve the quality of sleep,and have a positive impact on the restoration of immune function.

关 键 词：扁桃体切除术 睡眠呼吸暂停 阻塞性 言语参数测量 降钙素原 血小板膜糖蛋白类 T淋巴细胞亚群 儿童 

分 类 号：R749.79[医药卫生—神经病学与精神病学] R766.9[医药卫生—临床医学]