| Background and ObjectiveSleep disordered breathing(SDB)in children is characterized by partial or complete upper airway obstruction during sleep,which is often manifested as habitual snoring,dyspnea,and personality and behavior changes.At present,polysomnography is the gold standard for SDB diagnosis,but it has many limitations,such as high cost,poor coordination,complicated operation methods,and generally low acceptance by family members.Therefore,it is of great significance to find an acceptable alternative auxiliary examination for the diagnosis and treatment of children's SDB.Adenoid hypertrophy is the most common cause of SDB.Although the induction factors such as allergic diseases and microbial stimulation have been proved to be related to the occurrence and development of SDB,the pathogenesis of SDB has not been fully elucidated.lt has been reported that SDB can induce systemic inflammatory response and immune dysfunction,and some serum inflammatory factors can be used as inflammatory markers for SDB.To this end,this study took children with SDB as the research object to explore the relationship between serum inflammatory factors IL-2,IL-4,IL-6,IL-10,TNF-?,IFN-? and children's SDB and their clinical significance,so as to provide a theoretical basis for the diagnosis,treatment and disease assessment of children's SDB.Subjects and Methods1.Among the 68 children with SDB admitted to the department of pediatrics of the first affiliated hospital of zhengda university from September 2018 to December 2019,all of them met the diagnostic criteria of apnea index? 1 or percutaneous oxygen saturation?3%by artificial respiration count and blood oxygen monitoring.Among them,32 patients with A/N?50%were in the mild obstruction group(QZ group).36 patients with A/N>50%were in the moderate and severe obstruction group(ZZ group).Eighteen healthy children under physical examination in our hospital were normal controls.2.Record with age,gender,height,weight,medical history collection(history of snoring,special history,history of rhinitis disease,allergy),children sleep questionnaire(OSA-18)score,nose pharynx ministry CT-nasopharyngeal adenoid body ratio(A/N)measurement,night sleep monitoring,using enzyme-linked immunosorbent method to detect serum IL-2,IL-4,IL-6,IL-10,TNF-?,IFN-?.3.SPSS 22.0 statistical analysis was used to compare the QZ group,ZZ group and control group in terms of questionnaire related symptoms,general data,AHI,and inflammatory factors.The correlation between serum inflammatory factors,A/N ratio and AHI was analyzed.Results1.Compared with the questionnaire results of ZZ group,QZ group and control group,there was no statistically significant difference in the difference between repeated colds,excessive snot,frequent tantrums,hyperactivity and difficulty in getting up in the morning(?2 values were 0.374,0.486,0.627,1.225 and 0.885,respectively,and P values were 0.829,0.784,0.731,0.542 and 0.643,respectively).Compared with QZ group and control group,ZZ group had a higher proportion of stuffy mouth breathing and daytime sleepiness(P<0.05).Compared with the control group,the results of the QZ group showed that loud snoring,breathing due to nasal congestion,daytime sleepiness and inattention occurred in a higher proportion(P<0.05).2.There was no statistically significant difference in age,sex and BMI between ZZ group,QZ group and control group(P>0.05).The OSA score of ZZ group was higher than that of QZ group and control group,and the difference was statistically significant(P values were 0.000 and 0.000,respectively).The OSA score of QZ group was higher than that of the control group,and the difference was statistically significant(P value was 0.000).3.The AHI of ZZ group were significantly higher than those of QZ group,with statistically significant differences(t values of 3.644,P values of 0.001).4.Comparison Serum levels of IL-6 and TNF-? in ZZ group were higher than that in QZ group,with statistically significant differences(P values were 0.043 and 0.000,respectively).Serum levels of IL-4,IL-6 and TNF-? in ZZ group were higher than that in control group,with statistically significant differences(P values of 0.002,0.000 and 0.000,respectively).Serum levels of IL-4,IL-6 and TNF-? in the QZ group were higher than those in the control group,with statistically significant differences(P values of 0.046,0.025 and 0.003,respectively).There was no statistically significant difference in serum IL-2,IL-10 and IFN-y levels between the three groups(P>0.05).5.The A/N ratio,IL-4,IL-6 and TNF-? levels in children with SDB were positively correlated with AHI(r=0.639,P=0.000;r=0.424,P=0.000;r-0.373,P-.0.002;r=0.406,P=:0.001).Serum levels of IL-2,IL-10 and IFN-y were not significantly correlated with AHI(r--0.034,P=0.780);r=-0.150,P=0.22 1;r=-0.078,P=0.525).Conclusions1.Children with SDB have systemic inflammatory response.2.Serum levels of IL-4,IL-6 and TNF-? can be used as objective indicators to evaluate the severity of children's SDB. |
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