Department of Otolaryngology, Nippon Medical School, Musashi Kosugi Hospital, Kanagawa, Japan.
Department of Otolaryngology, Nippon Medical School, Musashi Kosugi Hospital, Kanagawa, Japan.
Auris Nasus Larynx. 2024 Apr;51(2):236-241. doi: 10.1016/j.anl.2023.09.002. Epub 2023 Oct 8.
In children with obstructive sleep apnea (OSA) who underwent adenotonsillectomy (AT), we measured body height and weight using standard deviation (SD) scores, insulin-like growth factor 1 (IGF-1), and skeletal age using carpal radiography. We then compared these values before and after surgery with the aim of investigating postoperative improvements in growth hormone (GH) deficiency.
Subjects comprised 35 children between 2 and 9 years of age (21 boys, 14 girls; mean age, 5.85 ± 1.75 years). Respiratory event index (REI), 3 % oxygen desaturation index (3 % ODI), height SD score, body mass index (BMI) percentile, blood IGF-1 level, and skeletal age from carpal radiographs were measured before surgery and both 3 and 12 months after surgery, and compared.
Height SD score improved significantly from preoperatively (-0.44 ± 1.13) to both 3 months postoperatively (-0.22 ± 1.14) and 12 months postoperatively (-0.13 ± 0.94). However, no significant improvement in height SD score was seen from 3 months to 12 months after AT. BMI percentile improved significantly from preoperatively (35.6 ± 26.7) to both 3 months postoperatively (44.7 ± 26.5) and 12 months postoperatively (49.1 ± 22.15), with significant improvement also seen from 3 months to 12 months after AT. SD score for IGF-1 showed significant improvement from before (-0.57 ± 1.00) to 12 months after surgery (-0.12 ± 0.89). No significant improvement in the difference between skeletal and chronological ages was seen from before to after surgery, but the number of patients for whom skeletal age normalized from before to after surgery increased significantly (74.3 % vs. 94.3 %), and the number with advanced or delayed skeletal age decreased significantly (25.7 % vs. 5.7 %) CONCLUSION: Early improvements can be obtained with surgical treatment in children with OSA who have short height and poor weight gain due to GH deficiency.
通过对接受腺样体扁桃体切除术（adenotonsillectomy，AT）的阻塞性睡眠呼吸暂停（obstructive sleep apnea，OSA）患儿进行身高和体重标准差（standard deviation，SD）评分、胰岛素样生长因子 1（insulin-like growth factor 1，IGF-1）和腕骨 X 线摄影的骨骼年龄测量，比较手术前后这些值，以探讨术后生长激素（growth hormone，GH）缺乏的改善情况。
研究对象为 35 名 2 至 9 岁的儿童（21 名男孩，14 名女孩；平均年龄 5.85±1.75 岁）。术前、术后 3 个月和 12 个月分别测量呼吸事件指数（respiratory event index，REI）、3%氧减指数（3% oxygen desaturation index，3%ODI）、身高 SD 评分、体质指数（body mass index，BMI）百分位、血清 IGF-1 水平和腕骨 X 线摄影的骨骼年龄，并进行比较。
身高 SD 评分从术前（-0.44±1.13）显著改善至术后 3 个月（-0.22±1.14）和 12 个月（-0.13±0.94）。然而，AT 术后 3 个月至 12 个月，身高 SD 评分无显著改善。BMI 百分位从术前（35.6±26.7）显著改善至术后 3 个月（44.7±26.5）和术后 12 个月（49.1±22.15），AT 术后 3 个月至 12 个月也有显著改善。IGF-1 的 SD 评分从术前（-0.57±1.00）显著改善至术后 12 个月（-0.12±0.89）。术前至术后骨骼年龄与实际年龄的差异无显著改善，但从术前至术后骨骼年龄正常的患者数量显著增加（74.3% vs. 94.3%），骨骼年龄提前或延迟的患者数量显著减少（25.7% vs. 5.7%）。
对于因 GH 缺乏而身高矮小、体重增长不良的 OSA 患儿，手术治疗可获得早期改善。
