儿童OSA中的低压缺氧与间歇性缺氧：与心脏应激的关联
Hypobaric and intermittent hypoxia in pediatric OSA: Associations with cardiac stress.
文献信息
| PMID | 42790253 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Diana Carolina De la Hoz Díaz-Granados |
| 作者单位 | Fundación Neumológica Colombiana, Carrera 13B No. 161-85, Bogotá, 110221, Colombia; Master's Program in Clinical Epidemiology, Faculty of Medicine, Universidad Nacional de Colombia, Carrera 45 No. 26-85, Bogotá, 111321, Colombia. Electronic address: dcdeg@unal.edu.co. |
| 期刊 | Sleep medicine |
| SCI 分区 | Q1 |
| IF | 4.5 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 探讨居住在高海拔地区的儿童中，阻塞性睡眠呼吸暂停（OSA）是否与pro-B型利钠肽及其N末端片段（proBNP/NT-proBNP，一种心肌壁应力血液标志物）以及超声心动图测量的心脏大小和功能相关。
方法： 274名居住在哥伦比亚波哥大（海拔2660米）的5-16岁儿童接受了整夜多导睡眠监测，并由此得出OSA及缺氧负荷指标（氧减饱和度指数、血氧饱和度低于90%的睡眠时间百分比）。采用酶联免疫吸附测定法检测血清proBNP/NT-proBNP和白细胞介素-10（IL-10，一种抗炎细胞因子），并由儿科心脏病专家进行超声心动图检查。
统计分析： proBNP/NT-proBNP采用中位数回归分析，并校正性别和体重指数z评分；六项超声心动图结局采用Holm校正进行检验；缺氧负荷和IL-10分析为探索性分析。
结果： 187名（68%）儿童患有OSA。患有OSA的儿童proBNP/NT-proBNP中位数更高（校正中位数比1.56，95%置信区间1.02-2.39）。校正后，没有任何超声心动图结局存在差异（所有Holm校正p值≥0.14）。在探索性分析中，较高的氧减饱和度指数与较高的proBNP/NT-proBNP相关（p=0.014），但在错误发现率校正后这一关联未能保持（q=0.22）。IL-10分析为探索性分析。
结论： 在居住在海拔2660米的儿童中，OSA与较高的proBNP/NT-proBNP相关，但与超声心动图差异无关。需要开展纵向、多海拔研究。
英文摘要
OBJECTIVE: To examine whether obstructive sleep apnea (OSA) is associated with pro-B-type natriuretic peptide and its N-terminal fragment (proBNP/NT-proBNP), a blood marker of myocardial wall stress, and with echocardiographic measures of cardiac size and function in children living at high altitude.
METHODS: 274 children aged 5-16 years living in Bogotá, Colombia (2660 m) underwent overnight polysomnography, from which OSA and hypoxic-burden measures (oxygen desaturation index, percentage of sleep time with oxygen saturation below 90%) were derived. Serum proBNP/NT-proBNP and interleukin-10 (IL-10, an anti-inflammatory cytokine) were measured by enzyme-linked immunosorbent assay, and pediatric cardiologists performed echocardiography.
STATISTICAL ANALYSIS: proBNP/NT-proBNP was analysed with median regression adjusted for sex and body mass index z-score; six echocardiographic outcomes were tested with Holm correction; hypoxic-burden and IL-10 analyses were exploratory.
RESULTS: 187 (68%) children had OSA. Median proBNP/NT-proBNP was higher with OSA (adjusted ratio of medians 1.56, 95% confidence interval 1.02-2.39). No echocardiographic outcome differed after correction (all Holm-adjusted p ≥ 0.14). In exploratory analyses, a higher oxygen desaturation index was associated with higher proBNP/NT-proBNP (p = 0.014), but this did not remain after false-discovery-rate correction (q = 0.22). IL-10 analyses were exploratory.
CONCLUSIONS: In children living at 2660 m, OSA was associated with higher proBNP/NT-proBNP but not with echocardiographic differences. Longitudinal, multi-altitude studies are needed.