Tam Charmaine S, Wong Melanie, McBain Rachel, Bailey Sherryn, Waters Karen A
SIDS and Sleep Apnoea Research Group, The Children's Hospital at Westmead, New South Wales, Australia.
J Paediatr Child Health. 2006 May;42(5):277-82. doi: 10.1111/j.1440-1754.2006.00854.x.
To evaluate a range of inflammatory measures in children with obstructive sleep apnoea (OSA).
In total, 44 children with polysomnographically defined OSA (30 boys; mean age: 7.3 +/- 3.7 years) and 69 control subjects (44 boys; mean age: 7.6 +/- 4 years) were recruited. Controls were screened for symptoms of OSA by questionnaire at the time of elective surgery that was unrelated to the upper airway. Blood samples were analysed for C-reactive protein, and cytokines IL-1beta, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, GM-CSF, IFN-gamma and TNF-alpha.
The majority of the children had mild OSA (32/44). Children with OSA (respiratory disturbance index 5.3 +/- 6.5 events/h) had significantly higher IFN-gamma and IL-8 levels than controls (P < 0.001 and 0.003, respectively), although correction for age, sex and body mass index reduced these differences (IFN-gammaP = 0.002, and IL-8 P = 0.051). There were no significant correlations between inflammatory measures and body mass index, respiratory disturbance index, or other sleep, desaturation, or arousal parameters including respiratory or spontaneous arousal indices, desaturation index or severity, sleep efficiency, or apnoea/hypopnoea duration in the OSA group.
Children with OSA, even of mild severity, have significantly elevated IFN-gamma levels and a trend towards elevated IL-8 levels compared with asymptomatic controls, consistent with a pro-inflammatory effect of OSA. These changes seen in mild OSA may precede changes in other pro-inflammatory cytokines found in studies of adults with more severe and long-standing disease, implying a potential benefit from early disease identification and intervention.
评估阻塞性睡眠呼吸暂停（OSA）患儿的一系列炎症指标。
共招募了44名经多导睡眠图确诊为OSA的儿童（30名男孩；平均年龄：7.3±3.7岁）和69名对照受试者（44名男孩；平均年龄：7.6±4岁）。在进行与上呼吸道无关的择期手术时，通过问卷调查对对照受试者进行OSA症状筛查。分析血样中的C反应蛋白以及细胞因子白细胞介素-1β、白细胞介素-2、白细胞介素-4、白细胞介素-6、白细胞介素-8、白细胞介素-10、白细胞介素-12、粒细胞-巨噬细胞集落刺激因子、干扰素-γ和肿瘤坏死因子-α。
大多数儿童患有轻度OSA（32/44）。OSA患儿（呼吸紊乱指数为5.3±6.5次/小时）的干扰素-γ和白细胞介素-8水平显著高于对照组（分别为P<0.001和0.003），尽管校正年龄、性别和体重指数后这些差异有所减小（干扰素-γ P = 0.002，白细胞介素-8 P = 0.051）。在OSA组中，炎症指标与体重指数、呼吸紊乱指数或其他睡眠、血氧饱和度下降或觉醒参数（包括呼吸或自发觉醒指数、血氧饱和度下降指数或严重程度、睡眠效率或呼吸暂停/低通气持续时间）之间无显著相关性。
与无症状对照组相比，OSA患儿即使病情较轻，其干扰素-γ水平也显著升高，白细胞介素-8水平有升高趋势，这与OSA的促炎作用一致。在轻度OSA中观察到的这些变化可能先于在患有更严重和长期疾病的成人研究中发现的其他促炎细胞因子的变化，这意味着早期疾病识别和干预可能具有潜在益处。
