目的 分析阻塞性睡眠呼吸暂停(OSA)儿童尿液肾上腺素、去甲肾上腺素、γ-氨基丁酸(GABA)及牛磺酸水平与认知行为损害之间的关系,为预测OSA儿童认知行为损害提供科学依据。 方法 纳入2023年2月—2024年2月因夜眠打鼾于苏州大学附属儿童医院呼吸科就诊,经多导睡眠监测(PSG)诊断为OSA的74例患儿为研究对象,选择同期诊断为鼾症(PS)的30例患儿作为对照,对比儿童生存质量量表(PedsQL)得分和尿液肾上腺素、去甲肾上腺素、GABA及牛磺酸水平。 结果 OSA儿童PedsQL的学校(t=2.596, P=0.011)及社交(Z=2.506, P=0.012)功能得分低于PS组;与PS及OSA不伴认知行为损害组相比,OSA伴认知行为损害组具有更高的尿液肾上腺素(F=25.725, P<0.001)以及更低的牛磺酸(F=9.515, P<0.001)水平。Logistic回归分析结果显示尿液肾上腺素(OR=1.023, 95%CI: 1.001~1.046, P=0.041)及牛磺酸(OR=0.985, 95%CI: 0.974~0.997,P=0.014)是OSA儿童认知行为损害的显著影响因素。结论 尿液肾上腺素和牛磺酸在OSA儿童中呈异常表达,其牛磺酸水平对OSA儿童认知行为损害有一定影响。
Abstract
Objective To investigate the association of urinary levels of epinephrine, norepinephrine, γ-aminobutyric acid (GABA), and taurine with cognitive-behavioral impairment in children with obstructive sleep apnea (OSA), in order to provide scientific evidence for predicting cognitive-behavioral impairment in these patients. Methods A total of 74 children diagnosed with OSA by polysomnography (PSG) at the Respiratory Department of Children′s Hospital of Soochow University between February 2023 and February 2024 were selected as study subjects, along with 30 children with primary snoring (PS) as controls.The Pediatric Quality of Life Inventory (PedsQL) scores and urinary levels of epinephrine, norepinephrine, GABA, and taurine were compared between groups. Results Compared to the PS group, children with OSA exhibited significantly lower PedsQL scores in school functioning (t=2.596, P=0.011) and social functioning (Z=2.506, P=0.012).The OSA group with cognitive-behavioral impairment demonstrated higher urinary epinephrine (F=25.725, P<0.001) and lower taurine levels (F=9.515, P<0.001) than both the PS group and OSA group without cognitive-behavioral impairment.Logistic regression analysis identified urinary epinephrine (OR=1.023, 95%CI: 1.001 - 1.046, P=0.041) and taurine (OR=0.985, 95%CI: 0.974 - 0.997, P=0.014) as significant independent predictors of cognitive-behavioral impairment in children with OSA. Conclusion Urinary epinephrine and taurine levels are dysregulated in children with OSA, with taurine demonstrating a potential protective effect against cognitive-behavioral impairment.
关键词
阻塞性睡眠呼吸暂停 /
认知行为损害 /
神经递质 /
儿童
Key words
obstructive sleep apnea /
cognitive impairment /
neurotransmitters /
children
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基金
苏州市科技发展计划(SKY2021009);苏州市临床病种重点专项(LCZX202206);江苏省卫健委医学科研项目(K2023055)
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