ABSTRACT
Objective To discuss the variation in serum factor IL-6,anti-inflammatory cytokine IL-10,and vascular cell adhesion molecule-1 (ICAM-1) level of children with obstructive sleep apnea-hypopnea syndrome (OSAHS) and their clinical significances.Methods One hundred and forty-two hospitalized children were divided into 2 groups:OSAHS group (47 cases) and the control group (95 cases),according to test result of polysomnography (the golden standard).The differences of IL-6,IL-10,high-sensitivity C-reactive protein (hsCRP) and ICAM-1 level between the two groups were measured and compared by using enzyme linked immunosorbent assay,and correlation analysis between IL-6,IL-10,ICAM-1 and each sleep-breathing parameter of OSAHS group was performed.The children of OSAHS group were divided into 3 groups:mild,moderate and severe group,according to the level of apnea hypopnea index(AHI).Statistical analysis was performed on the above indexes among the 3 groups.Reassessment of the children diagnosed with OSAHS was performed after 12 weeks of treatment.Results The serum levels of IL-6,ICAM-1 and hsCRP [(2.98 ± 0.27) ng/L,(391.7 ± 115.6) μg/L,(15.4 ± 4.9) mg/L] of OSAHS group were significantly higher than those of the control group[(1.67 ± 0.07) rng/L,(189.8 ± 106.4) μg/L,(2.5 ± 2.1) mg/L],while its serum IL-10 level was lower than that of the control group[(195.2 ± 33.6) ng/L vs (458.5 ± 102.2)ng/L],and there were significant differences between the 2 groups (t =33.26,32.45,10.94,-53.72,all P ＜0.01) ; there were significant differences in terms of IL-6,IL-10 and ICAM-1 level among the mild,the moderate and the severe groups (F =128.90,102.60,8.25,all P ＜0.05).Of which the serum levels of IL-6,ICAM-1 and hsCRP of the severe group[(3.22 0.27) ng/L,(427.7 ± 95.4) μg/L,(21.0 ± 3.9) mg/L] were higher than those of the mild group [(1.92 ± 0.24) ng/L,(236.5 ± 115.6) μg/L,(11.0 ± 3.8) mg/L] and the moderate group [(2.02 ± 0.31) ng/L,(401.5 ± 105.6) μg/L,(17.0 ± 2.8)mg/L],and serum levels of IL-6,ICAM-1 as well as hsCRP were increased accompanied with the raise of AHI.While the serum level of IL-10[(115.2 ±30.6) ng/L] in the severe group was lower than that of the mild and the moderate groups [(400.2 ± 55.6) ng/L,(203.2 ± 27.6) ng/L] ; serum levels of IL-6 and ICAM-1 of OSAHS children were positively correlated with AHI and micro-arousal index (r =0.341,0.427,all P ＜0.05),negatively correlated with lowest oxygen saturation (LSaO2) at night (r =-0.190,P ＜ 0.01),and without correlation with body mass index (BMI) (r =-0.121,P ＞ 0.05).Serum level of IL-10 was negatively correlated with AHI (r =-0.266,P ＜ 0.05),positively correlated with LSaO2 (r =0.240,P ＜ 0.01),and without correlation with BMI or micro-arousal index (r =-0.183,-0.159,all P ＞ 0.05) ; After 12-week treatment,the IL-6 and ICAM-1 levels of OSAHS group [(2.02 ± 0.13)ng/L,(269.9 ± 107.2) μg/L] were decreased,while IL-10 [(476.3 ± 86.t2) ng/L] were increased compared with pre-treatment[(3.08 ± 0.30) ng/L,(187.2 ± 29.63) ng/L,(379.9 ± 105.2) μg/L] (t =24.22,22.32,66.96,all P ＜ 0.05).Conclusions OSAHS children have systemic inflammatory response,which may increase the risk of cardiovascular disease; this inflammatory response is reversible,so early identification and treatment of OSAHS is beneficial.