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儿童阻塞性睡眠呼吸暂停症中血小板计数和凝血参数的变化。

Changes in platelet count and coagulation parameters in children with obstructive sleep apnea.

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Department of Otorhinolaryngology Head and Neck Surgery, Chengdu Shangjin Nanfu Hospital, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

Sleep Breath. 2022 Jun;26(2):871-878. doi: 10.1007/s11325-021-02443-8. Epub 2021 Jul 22.

Abstract

OBJECTIVE

To investigate the correlation between obstructive sleep apnea (OSA) and coagulation status and to speculate on the underlying mechanism in children with OSA.

METHODS

We divided 345 children with OSA (age 2-14 years) into four groups according to the apnea-hypopnea index (AHI). We compared platelet (PLT) and coagulation parameters among groups. Correlations between the polysomnography parameters and coagulation parameters were investigated.

RESULTS

Children with OSA had higher PLT counts than those without OSA (P < 0.001), while no significant difference was observed in prothrombin time, international normalized ratio, activated partial thromboplastin time, thrombin time, or fibrinogen among children with/without OSA. In linear regression analysis, the AHI and oxygen desaturation index (ODI) presented positive correlation with the PLT count (R = 0.155, beta = 0.307, P < 0.001 and R = 0.113, beta = 0.262, P < 0.001), and there was no correlation among the AHI, ODI, and other coagulation parameters. The minimum and mean oxygen saturation of arterial blood manifested negative correlation with the PLT count (R = 0.076, beta =  - 0.116, P = 0.034 and R = 0.083, beta =  - 0.140, P = 0.008, respectively).

CONCLUSIONS

Children with OSA have a higher PLT count, positively correlated with OSA severity, and no evidence of coagulation disorder.

摘要

目的

探讨阻塞性睡眠呼吸暂停(OSA)与凝血状态的相关性,并推测 OSA 患儿中潜在的机制。

方法

我们根据呼吸暂停低通气指数(AHI)将 345 例 OSA 患儿(年龄 2-14 岁)分为四组。比较组间血小板(PLT)和凝血参数。分析多导睡眠图参数与凝血参数的相关性。

结果

OSA 患儿的 PLT 计数高于无 OSA 患儿(P < 0.001),而两组间凝血酶原时间、国际标准化比值、活化部分凝血活酶时间、凝血酶时间和纤维蛋白原均无显著差异。线性回归分析显示,AHI 和氧减指数(ODI)与 PLT 计数呈正相关(R = 0.155,β = 0.307,P < 0.001 和 R = 0.113,β = 0.262,P < 0.001),而 AHI、ODI 与其他凝血参数之间无相关性。动脉血最低和平均氧饱和度与 PLT 计数呈负相关(R = 0.076,β = -0.116,P = 0.034 和 R = 0.083,β = -0.140,P = 0.008)。

结论

OSA 患儿 PLT 计数较高,与 OSA 严重程度呈正相关,无凝血功能障碍证据。

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