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OSA对儿童体格生长发育影响的研究进展
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Abstract:
儿童阻塞性睡眠呼吸暂停综合征可导致儿童出现体格生长发育迟滞这一观点已经得到众多学者的公认。近年来随着家长对儿童OSA的重视,更多的学者进行了很多相关研究。本文主要是通过OSA对儿童体格生长发育造成的影响,产生影响的病理机制及早期治疗的效果这3个方面来系统性的论述。
The view that obstructive sleep apnea syndrome (OSA) in children can lead to growth retardation in children’s physical development has been widely recognized by many scholars. In recent years, with parents’ increasing attention to children’s OSA, more scholars have conducted numerous related studies. This article mainly discusses three aspects: the impact of OSA on children’s physical growth and development, the pathological mechanism of its impact, and the effectiveness of early treatment.
[1] | 中国儿童OSA诊断与治疗指南制订工作组, 中华医学会耳鼻咽喉头颈外科学分会小儿学组, 中华医学会儿科学分会呼吸学组, 等. 中国儿童阻塞性睡眠呼吸暂停诊断与治疗指南(2020) [J]. 中国循证医学杂志, 2020, 20(8): 883-900. |
[2] | 李文丽, 冯慧伟, 张辉, 等. 儿童阻塞性睡眠呼吸暂停低通气综合征患者骨龄和血清骨钙素的测定分析[J]. 山东大学耳鼻喉眼学报, 2012, 26(1): 15-18. |
[3] | 葛羽, 张学文, 胡影. 腺样体切除术后阻塞型睡眠呼吸暂停低通气综合征患儿骨龄和血清骨钙素的变化[J]. 中国现代医学杂志, 2021, 31(11): 65-70. |
[4] | Bar, A., Tarasiuk, A., Segev, Y., et al. (1999) The Effect of Adenotonsillectomy on Serum Insulin-Like Growth Factor-I and Growth in Children with Obstructive Sleep Apnea Syndrome. The Journal of Pediatrics, 135, 76-80. https://doi.org/10.1016/S0022-3476(99)70331-8 |
[5] | Nachalon, Y., Lowenthal, N., Greenberg-Dotan, S. and Goldbart, A.D. (2014) Inflammation and Growth in Young Children with Obstructive Sleep Apnea Syndrome before and after Adenotonsillectomy. Mediators of Inflammation, 2014, Article ID: 146893. https://doi.org/10.1155/2014/146893 |
[6] | Bassett, J.H. and Williams, G.R. (2016) Role of Thyroid Hormones in Skeletal Development and Bone Maintenance. Endocrine Reviews, 37, 135-187. https://doi.org/10.1210/er.2015-1106 |
[7] | Refetoff, S., Duncan Bassett, J.H., Beck-Peccoz, P., et al. (2014) Classification and Proposed Nomenclature for Inherited Defects of Thyroid Hormone Action, Cell Transport, and Metabolism. Thyroid, 24, 407-409. https://doi.org/10.1089/thy.2013.3393.nomen |
[8] | 王蓓, 刘卓拉, 宋满景. 生长激素对阻塞性睡眠呼吸暂停综合征患者代谢的影响[J]. 中华内科杂志, 1999, 38(10): 47-48. |
[9] | 赵忠新. 临床睡眠障碍学[M]. 上海: 第二军医大学出版社, 2003. |
[10] | 张一彤, 李青香, 石争浩, 等. 阻塞性睡眠呼吸暂停儿童睡眠结构研究及睡眠结构判读模型建立[J]. 山东大学耳鼻喉眼学报, 2023, 37(6): 126-132. |
[11] | 张丰珍, 王桂香, 许志飞, 等. 儿童重度OSAHS睡眠结构及相关因素分析[J]. 临床耳鼻咽喉头颈外科杂志, 2019, 33(5): 441-446.. |
[12] | Roche, J., Gillet, V., Perret, F. and Mougin, F. (2018) Obstructive Sleep Apnea and Sleep Architecture in Adolescents with Severe Obesity: Effects of a 9-Month Lifestyle Modification Program Based on Regular Exercise and a Balanced Diet. Journal of Clinical Sleep Medicine, 14, 967-976. https://doi.org/10.5664/jcsm.7162 |
[13] | Tal, A., Bar, A., Leiberman, A. and Tarasiuk, A. (2003) Sleep Characteristics Following Adenotonsillectomy in Children with Obstructive Sleep Apnea Syndrome. Chest, 124, 948-953. https://doi.org/10.1378/chest.124.3.948 |
[14] | Gong, Q.-H., Li, S.-X., Li, H., et al. (2018) 25-Hydroxyvitamin D Status and Its Association with Sleep Duration in Chinese Schoolchildren. Nutrients, 10, Article 1013. https://doi.org/10.3390/nu10081013 |
[15] | 谢利生, 黄群. 阻塞性睡眠呼吸暂停综合征患儿体内生长激素水平的变化[J]. 山东大学耳鼻喉眼学报, 2011, 25(4): 3-5. |
[16] | Buzi, F., Zanotti, P., Tiberti, A., et al. (1993) Overnight Growth Hormone Secretion in Short Children: Independence of the Sleep Pattern. The Journal of Clinical Endocrinology & Metabolism, 77, 1495-1499. https://doi.org/10.1210/jcem.77.6.8263132 |
[17] | Pepin, J.L., Galerneau, L.M., Borel, A.L., et al. (2016) IGF-1: A Marker of Cardio-Metabolic Risk in Obstructive Sleep Apnea (OSA) Syndrome? Endocrine Abstracts, 41, GP55. https://doi.org/10.1530/endoabs.41.GP55 |
[18] | Palm, A., Berne, C., Igelstr?m, H., ?senl?f, P., Janson, C. and Lindberg, E. (2018) The Impact of Continuous Positive Airway Pressure on Circulating IGF-1 in Patients with Obstructive Sleep Apnea. Journal of Clinical Sleep Medicine, 14, 385-391. https://doi.org/10.5664/jcsm.6982 |
[19] | Gozal, D., Sans Capdevila, O., McLaughlin Crabtree, V., Serpero, L.D., Witcher, L.A. and Kheirandish-Gozal, L. (2009) Plasma IGF-1 Levels and Cognitive Dysfunction in Children with Obstructive Sleep Apnea. Sleep Medicine, 10, 167-173. https://doi.org/10.1016/j.sleep.2008.01.001 |
[20] | Karalok, Z.S., Akdag, M., Turhan, M., et al. (2014) Leptin and Ghrelin Levels in Children before and after Adenoidectomy or Adenotonsillectomy. Hormone Research in Paediatrics, 81, 20-24. https://doi.org/10.1159/000355508 |
[21] | 侯瑾, 康全清, 郑国玺. 儿童阻塞性睡眠呼吸暂停低通气综合征与生长发育迟缓的关系[J]. 中华耳鼻咽喉头颈外科杂志, 2008, 43(3): 174-178. https://doi.org/10.3321/j.issn:1673-0860.2008.03.004 |
[22] | 曲斌斌, 徐德祥, 陈霞, 孙荣丽. 呼吸暂停综合征对胰岛素样生长因子-1与心泵功能的关联分析[J]. 临床肺科杂志, 2016, 21(9): 1589-1591, 1592. |
[23] | 孙晓燕, 范献良, 张红萍, 等. 儿童OSAHS患者血清IGF-1、IGFBP-3及甲状腺激素的检测及分析[J]. 山东大学耳鼻喉眼学报, 2009, 23(2): 27-30. |
[24] | Nieminen, P., L?pp?nen, T., Tolonen, U., Lanning, P., Knip, M. and L?pp?nen, H. (2002) Growth and Biochemical Markers of Growth in Children with Snoring and Obstructive Sleep Apnea. Pediatrics, 109, e55. https://doi.org/10.1542/peds.109.4.e55 |
[25] | Sen, T. and Ay?i?ek, A. (2010) Do Children with Adenotonsillar Hypertrophy Have Lower IGF-1 and Ghrelin Levels than the Normal Children? Journal of Tropical Pediatrics, 56, 213-215. https://doi.org/10.1093/tropej/fmp093 |
[26] | Ji, T., Lu, T., Qiu, Y., et al. (2020) The Efficacy and Safety of Montelukast in Children with Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis. Sleep Medicine, 78, 193-201. https://doi.org/10.1016/j.sleep.2020.11.009 |
[27] | Zhang, L., Mendoza Sassi, R., César, J.A., et al. (2006) Intranasal Corticosteroids for Nasal Airway Obstruction in Children with Adenoidal Hypertrophy. Cochrane Database of Systematic Reviews, No. 4, CD006286. https://doi.org/10.1002/14651858.CD006286 |
[28] | Liming, B.J., Ryan, M., Mack, D., et al. (2018) Montelukast and Nasal Corticosteroids to Treat Pediatric Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis. Otolaryngology-Head and Neck Surgery, 160, 594-602. https://doi.org/10.1177/0194599818815683 |
[29] | Blackshaw, H., Springford, L.R., Zhang, L.Y., Wang, B., Venekamp, R.P. and Schilder, A.G. (2020) Tonsillectomy versus Tonsillotomy for Obstructive Sleep-Disordered Breathing in Children. Cochrane Database of Systematic Reviews, No. 4, CD011365. https://doi.org/10.1002/14651858.CD011365.pub2 |
[30] | 刘然, 史敏, 黄永, 等. 鼻内镜下扁桃体腺样体等离子切除术对重度鼾症所致发育不良的治疗效果[J]. 中国内镜杂志, 2019, 25(4): 32-36. https://doi.org/10.3969/j.issn.1007-1989.2019.04.006 |