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目的探讨扁桃体腺样体切除术对睡眠呼吸障碍(SDB)儿童全身炎症的治疗作用。方法采用多导睡眠仪,对65例睡眠打鼾儿童进行整夜睡眠监测,并应用conners简明症状问卷评定儿童行为问题。比较阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与单纯鼾症儿童行手术前和手术1年后血清C反应蛋白水平的变化以及异常行为的改善情况。结果无论血清C反应蛋白含量还是Conners行为简明症状问卷得分在OSAHS儿童明显高于单纯鼾症及健康对照儿童;单纯鼾症儿童也明显高于健康对照组。在OSAHS组Conners行为简明症状问卷评分由行扁桃体腺样体手术前的14.2±3.8下降到手术后6.7±3.1,血清C反应蛋白含量由术前的(4.25±1.78)mg/L下降到术后的(3.23±1.45)mg/L(P<0.05),差异有统计学意义;单纯鼾症组Conners行为简明症状问卷评分由术前的9.4±4.1下降到术后5.1±2.8,血清C反应蛋白含量由术前的(2.77±1.80)mg/L下降到术后的(1.76±0.81)mg/L(P<0.05),差异有统计学意义。结论SDB儿童有较多的行为问题出现以及较高的血清C反应蛋白水平。扁桃体腺样体切除术对SDB儿童行为异常有明显的治疗作用,同时血清C反应蛋白水平也明显的下降。
Objective To investigate the therapeutic effect of tonsillectomy on systemic inflammation in children with sleep disordered breathing (SDB). Methods Sixty-five sleep-snoring children were monitored with polysomnography for overnight sleep. The conners concise symptom questionnaire was used to assess children’s behavioral problems. To compare the changes of serum C-reactive protein level and abnormal behavior before and after operation in children with obstructive sleep apnea-hypopnea syndrome (OSAHS) and simple snoring. Results Regardless of serum C-reactive protein content or Conners Concise Symptom Questionnaire score in OSAHS children was significantly higher than simple snoring and healthy children; snoring children were also significantly higher than the healthy control group. In the OSAHS group, the Conners Concise Symptom Questionnaire score decreased from 14.2 ± 3.8 before surgery to 6.7 ± 3.1 after surgery, and the serum C-reactive protein level decreased from 4.25 ± 1.78 mg / L preoperatively to (3.23 ± 1.45) mg / L (P <0.05), the difference was statistically significant. Conners’ behavior concise symptom questionnaire score in simple snoring group decreased from 9.4 ± 4.1 preoperatively to 5.1 ± 2.8 postoperatively, serum C-reactive protein The content decreased from (2.77 ± 1.80) mg / L preoperatively to (1.76 ± 0.81) mg / L postoperatively (P <0.05), the difference was statistically significant. Conclusion SDB children have more behavioral problems and higher serum C-reactive protein levels. Adenotonsillectomy has a significant therapeutic effect on behavioral abnormalities in SDB children, meanwhile, serum C-reactive protein level also decreases obviously.