变态反应与儿童OSAHS的关系

doi:10.6040/j.issn.1673-3770.1.2018.002

摘要/Abstract

摘要： 儿童OSAHS为耳鼻喉科常见病,其发病率高,且严重危害儿童生长发育。儿童OSAHS的发病与多种因素有关,其中最常见的原因是扁桃体肥大及腺样体肥大。扁桃体和腺样体均为淋巴组织,位于消化道、呼吸道的入口处且长期接触各种食入、吸入性变应原的刺激,越来越多的研究表明,变态反应在儿童OSAHS的发病中起一定作用,但对此也有不同的观点被提出。对变态反应与儿童OSAHS的关系进行综述,为儿童OSAHS的内科治疗提供依据。

关键词: 睡眠呼吸暂停, 变应原, 扁桃体肥大腺样体肥大, 阻塞性, 儿童

Abstract: Children obstructive sleep apnea hypopnea syndrome, which have the high incidence, endangering children growth seriously, is a kind of ENT common diseases. The high incidence of OSAHS in children is related to many factors, the most common of that is tonsil hypertrophy and adenoid hypertrophy. Tonsils and adenoids are lymphatic tissues, locating at the entrance to the digestive tract and respiratory tract, and exposing to various ingestion and allergens for a long time. More and more studies have shown that allergic reactions play an important role in the pathogenesis of OSAHS in children, however, different opinions have also been put forward. This article summarizes the latest research results, and the relationship between allergic reactions and OSAHS in children, and then provides the basis for the medical treatment of children OSAHS.

Key words: Children, Allergy, adenotonsillar hypertrophy, Sleep apnea, obstructive

中图分类号:

R766.7

王岩,师晓丽. 变态反应与儿童OSAHS的关系[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 14-18.

WANG Yan, SHI Xiaoli. The relationship between allergic reaction and children obstructive sleep apnea hypopnea syndrome[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2018, 32(2): 14-18.

参考文献

[1] 中华耳鼻咽喉头颈外科杂志编委会, 中华医学会耳鼻咽喉科学分会. 儿童阻塞性睡眠呼吸暂停低通气综合征诊疗指南草案(乌鲁木齐)[J]. 中华耳鼻咽喉头颈外科杂志, 2007, 42(2): 83-84. Editorial Board of Chinese Journal of Otorhinolary. Chinese Otorhinolaryngology of Chinese Medical Ass. Draft of guidelines for the diagnosis and treatment of pediatric sleep apnea hypopnea syndrome(Urumqi)[J].Chin J Otorhinolaryngol Head Neck Surg, 2007, 42(2):83-84.
[2] Sadeghi-Shabestari M, Jabbari Moghaddam Y, Ghaharri H. Is there any correlation between allergy and adenotonsillar tissue hypertrophy? [J]. Int J Pediatr Otorhinolaryngol, 2011, 75(4): 589-591.
[3] 杨素娜, 窦训武. 100例腺样体肥大儿童的血清过敏原检测分析 [J]. 中外医学研究, 2016, 14(11): 42-43. YANG Suna,DOU Xunwu. Serum allergen detection and analysis for 100 cases of adenoid hypertrophy[J]. Chin Foreign Med Res, 2016, 14(11): 42-43.
[4] Olusesi AD, Undie NB, Amodu JE. Allergy history as a predictor of early onset adenoids/adenotonsillar hypertrophy among Nigerian children [J]. Int J Pediatr Otorhinolaryngol, 2013, 77(6): 1032-1035.
[5] Ameli F, Brocchetti F, Tosca MA, et al. Adenoidal hypertrophy and allergic rhinitis: is there an inverse relationship? [J]. Am J Rhinol Allergy,2013, 27(1): 5-10.
[6] Nuhoglu C, Nuhoglu Y, Bankaoglu M, et al. A retrospective analysis of adenoidal size in children with allergic rhinitis and nonallergic idiopathic rhinitis [J]. Asian Pac J Allergy Immunol, 2010, 28(2-3): 136-140.
[7] Karaca CT, Toros SZ, Noseri H, et al. Role of allergy in children with adenotonsillar hypertrophy [J]. J Craniofac Surg, 2012, 23(6): 611-613.
[8] Ameli F, Brocchetti F, Tosca MA, et al. Tonsil volume and allergic rhinitis in children [J]. Allergy Rhinol(Providence), 2014, 5(3): 137-142.
[9] Chng SY, Goh DY, Wang XS, et al. Snoring and atopic disease: a strong association [J]. Pediatr Pulmonolo, 2004, 38(3): 210-216.
[10] 施俊, 吕静荣, 吴皓. 未合并变应性鼻炎及哮喘的OSAHS儿童血清Th1/Th2细胞因子检测及临床意义 [J]. 临床耳鼻咽喉头颈外科杂志, 2012, 26(23): 1073-1076. SHI Jun, LÜ Jingrong, WU Hao. Th1/Th2 cytokines and its clinical significance in obstructive sleep apnea hypopnea syndrome children without allergic rhinitis and asthma[J]. Clin J Otorhinolarynol Head Neck Surg, 2012, 26(23): 1073-1076.
[11] Kumar RK, Webb DC, Herbert C, et al. Interferon-gamma as a possible target in chronic asthma [J]. Inflamm Allergy Drug Targets, 2006, 5(4): 253-256.
[12] Cao J, Que C, Wang G, et al. Effect of posture on airway resistance in obstructive sleep apnea-hypopnea syndrome by means of impulse oscillation[J]. Respiration, 2009, 77(1): 38-43.
[13] Zhang J, Zhao J, Chen M, et al. Airway resistance and allergic sensitization in children with obstructive sleep apnea hypopnea syndrome [J]. Pediatr Pulmonolo 2016, 51(4): 426-430.
[14] 王丰, 周成勇, 张京红, 等. 儿童OSAHS和变应性鼻炎的关系探讨[J]. 临床耳鼻咽喉头颈外科杂志, 2012, 26(6): 260-262. WANG Feng, ZHOU Chengyong, ZHANG Jinghong, et al. Correlation between allergic rhinitis and childhood obstructive sleep apnea-hypopnea syndrome[J]. Clin J Otorhinolarynol Head Neck Surg, 2012, 26(6): 260-262.
[15] 杨扬, 张杰, 陈敏, 等. 变应性鼻炎对儿童阻塞性睡眠呼吸暂停低通气综合征的影响[J]. 山东大学耳鼻喉眼学报, 2015, 29(3): 6-8. YANG Yang, ZHANG Jie, CHEN Min, et al. Effect of allergic rhinitis on obstructive sleep apnea hypopnea syndrome in children[J]. J Otolaryngol Ophthalmol Shandong Univ, 2015, 29(3): 6-8.
[16] Evcimik MF, Dogru M, Cirik AA, et al. Adenoid hypertrophy in children with allergic disease and influential factors [J]. Int J Pediatr Otorhinolaryngol, 2015, 79(5): 694-697.
[17] Dogru M, Evcimik MF, Calim OF. Does adenoid hypertrophy affect disease severity in children with allergic rhinitis? [J]. Eur Arch Otorhinolaryngol, 2017, 274(1): 209-213.
[18] Friedman M, Maley A, Kelley K, et al. Impact of nasal obstruction on obstructive sleep apnea [J]. Otolaryngol Head Neck Surg, 2011, 144(6): 1000-1004.
[19] Loehrl TA, Smith TL, Darling RJ, et al. Autonomic dysfunction, vasomotor rhinitis, and extraesophageal manifestations of gastroesophageal reflux[J]. Otolaryngol Head Neck Surg, 2002, 126(4): 382-387.
[20] Wu J, Gu M, Chen S, et al. Factors related to pediatric obstructive sleep apnea-hypopnea syndrome in children with attention deficit hyperactivity disorder in different age groups [J]. Medicine, 2017, 96(42): e8281.
[21] Tsai JD, Chen HJ, Ku MS, et al. Association between allergic disease, sleep disordered breathing, and childhood nocturnal enuresis: a population-based case-control study[J]. Pediatr Nephrol, 2017, 32(12):2293-2301.
[22] Zheng M, Wang X, Zhang. LAssociation between allergic and nonallergic rhinitis and obstructive sleep apnea[J]. Curr Opin Allergy Clin Immunol, 2018, 18(1):16-25.
[23] Lee DJ, Chung YJ, Yang YJ, et al. The Impact of Allergic Rhinitis on Symptom Improvement in Pediatric Patients After Adenotonsillectomy[J]. Clin Exp Otorhinolaryngol, 2018, 11(1):52-57.
[24] Kim DK, Han DH. Impact of allergic rhinitis on quality of life after adenotonsillectomy for pediatric sleep-disordered breathing[J]. Int Forum Allergy Rhinol, 2015, 5(8): 741-746.
[25] Tagaya M, Nakata S, Yasuma F, et al. Children with severe or moderate obstructive sleep apnoea syndrome show a high incidence of persistence after adenotonsillectomy[J]. Acta Otolaryngol, 2012, 132(11): 1208-1214.
[26] Zhang Q, Li D, Wang H. Long term outcome of tonsillar regrowth after partial tonsillectomy in children with obstructive sleep apnea [J]. Auris Nasus Larynx, 2014, 41(3): 299-302.
[27] Huo Z, Shi J, Shu Y, et al. The relationship between allergic status and adenotonsillar regrowth: a retrospective research on children after adenotonsillectomy[J]. Sci Rep, 2017, 7:46615.
[28] Marchisio P, Varricchio A, Baggi E, et al. Hypertonic saline is more effective than normal saline in seasonal allergic rhinitis in children[J]. Int J Immunopathol Pharmacol, 2012, 25(3): 721-730.
[29] 岳耀光, 黄合银, 黄丽芳, 等. 舌下含服粉尘螨滴剂治疗儿童变应性鼻炎合并腺样体肥大的疗效观察 [J]. 山东大学耳鼻喉眼学报, 2014, 28(3): 16-19. YUE Yaoguang, HUANG Heyin, HUANG Lifang, et al. Efficacy of specific sublingual immunotherapy with dermatophagoides farinae drops on allergic rhinitis and ade-noid hypertrophy in children[J]. J Otolaryngol Ophthalmol Shandong Univ, 2014, 28(3): 16-19.

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