血清miR-181b在儿童阻塞性睡眠呼吸暂停低通气综合征中的作用及意义

宣妙燕 郁峰 黄秋玲 蔡尧梁

[摘要] 目的 探討血清miR-181b在儿童阻塞性睡眠呼吸暂停低通气综合征（OSAHS）中的作用及意义。 方法 选取2018年1—12月湖州市中心医院收治的OSAHS患儿60例，经多导睡眠监测仪监测，按照病情分为轻度OSAHS组与中重度OSAHS组，每组各30例。选取同一时期来湖州市中心医院进行健康体检的无OSAHS症状患儿30例为对照组。对受试者进行Achenbach儿童行为量表（CBCL）检测、韦氏儿童智力量表（WWISC）检测，以及血清神经元特异性烯醇化酶（NSE）、S100β、miR-181b水平检测。 结果 轻度、中重度OSAHS组CBCL评分，NSE、S100β、miR-181b水平显著高于对照组;中重度OSAHS组CBCL评分、NSE、S100β、miR-181b水平显著高于轻度OSAHS组，WISC显著低于轻度OSAHS组（P<0.05）。OSAHS患者血清miR-181b水平与NSE、S100β水平、CBCL评分均呈显著正相关（P<0.05），与WISC呈显著负相关（P<0.05）。 结论 通过对血清中的miR-181b水平进行检测，能够对OSAHS患儿认知行为障碍的程度、脑损伤的程度进行早期的筛查，提高诊断水平。

[关键词] 阻塞性睡眠呼吸暂停低通气综合征;认知行为障碍;脑损伤;miR-181b

[中图分类号] R563.9          [文献标识码] A          [文章编号] 1673-9701（2021）09-0005-05

The role and significance of serum miR-181b in children with obstructive sleep apnea- hypopnea syndrome

XUAN Miaoyan   YU Feng   HUANG Qiuling   CAI Yaoliang

Department of Pediatrics， Huzhou Central Hospital in Zhejiang Province， Affiliated Hospital of Huzhou University， Huzhou   313000， China

[Abstract] Objective To explore the role and significance of serum miR-181b in children with obstructive sleep apnea-hypopnea syndrome（OSAHS）. Methods Sixty children with OSAHS admitted to Huzhou Central Hospital from January to December 2018 were selected as the subjects. They were monitored by polysomnography and divided into mild OSAHS group and moderate-severe OSAHS group according to their condition， with 30 cases in each group. Thirty children with no OSAHS symptoms who came to Huzhou Central Hospital for physical examination during the same period were selected as the control group. All subjects were tested with achenbach child behavior checklist（CBCL）， wechsler intelligence scale for children （WISC）， serum neuron-specific enolase（NSE）， S100β， and miR-181b level. Results The CBCL scores， NSE， S100β， and miR-181b levels of the mild and moderate-severe OSAHS groups were significantly higher than those of the control group. The CBCL scores， NSE， S100β， and miR-181b levels of the moderate-to-severe OSAHS group were significantly higher than those of the mild OSAHS group. WISC of the moderate-to-severe OSAHS group was significantly lower than that of the mild OSAHS group（P<0.05）. Serum miR-181b levels in OSAHS patients were significantly positively correlated with NSE， S100β levels， and CBCL scores（P<0.05）， and significantly negatively correlated with WISC（P<0.05）. Conclusion By detecting the level of miR-181b in the serum， early screening of the degree of cognitive behavioral impairment and the degree of brain damage in children with OSAHS can be carried out to improve the level of diagnosis.

[Key words] Obstructive sleep apnea-hypopnea syndrome; Cognitive behavior disorder; Brain injury; miR-181b

阻塞性睡眠呼吸暂停低通气综合征（Obstructive sleep apnea-hypopnea syndrome，OSAHS）是由于各种原因导致的上呼吸道部分或全部阻塞，从而扰乱睡眠过程中正常通气过程和睡眠结构的疾病[1]。OSAHS的发生不仅影响睡眠质量，还与高血压、心血管疾病等疾病的发生发展密切相关，影响患者的健康與生活质量，据统计，OSAHS在儿童中的患病率达1.2%～5.7%[2]。儿童的身体结构与机能与成人存在较大差异，OSAHS可影响患儿身体及智力发育[3]。目前，对OSAHS患儿进行早期筛查，并制定个体化的治疗和管理方案已成为该领域研究的热点。近年来相关血清生物标志物的表达与OSAHS关系成为研究热点。微小核糖核酸（microRNA，miRNA）表达异常参与多种脑疾病的发病过程[4]，本研究分析血清miR-181b与OSAHS儿童脑损伤、认知行为障碍的关系，现报道如下。……