睡眠呼吸障碍伴腺样体和/或扁桃体肥大患儿血常规指标变化的临床分析

Analysis of changes in blood routine indices in children with sleep-disordered breathing with adenoid and/or tonsil hypertrophy

摘要:

目的 分析睡眠呼吸障碍(SDB)伴腺样体和/或扁桃体肥大(ATH)患儿血常规指标变化的临床意义，为儿童SDB的病情评估和预后评价提供一定的科学依据。方法 选取2023年10月—2024年8月在大理大学第一附属医院耳鼻咽喉科住院治疗的60例诊断为SDB伴ATH的患儿作为病例组，选取同期于本院体检的60名健康儿童作为对照组，病例组患儿均行腺样体和/或扁桃体切除术，术后3个月返院复查。分别对比SDB患儿与健康儿童、SDB患儿手术前后的血常规指标变化。结果 病例组和对照组儿童的白细胞计数(WBC)、中性粒细胞百分比(N%)、淋巴细胞百分比(L%)、单核细胞百分比(MO%)、嗜酸性粒细胞百分比(EO%)、嗜碱性粒细胞百分比(BA%)、中性粒细胞计数(N#)、淋巴细胞计数(L#)、单核细胞计数(MO#)、嗜酸性粒细胞计数(EO#)、嗜碱性粒细胞计数(BA#)、红细胞计数(RBC)、血红蛋白(HGB)、红细胞压积(HCT)、红细胞平均体积(MCV)、平均红细胞血红蛋白量(MCH)、平均红细胞血红蛋白浓度(MCHC)、红细胞分布宽度(RDW，包括变异系数RDW-CV、标准差RDW-SD)、血小板计数(PLT)、血小板压积(PCT)等指标差异无统计学意义(P＞0.05)；病例组平均血小板体积(MPV)、血小板分布宽度(PDW)、大血小板比例(P-LCR)均高于对照组，差异具有统计学意义(P＜0.05)。病例组MPV、PDW、P-LCR水平与年龄均呈正相关(r=0.322，P＜0.05；r=0.376，P＜0.05；r=0.349，P＜0.05)。病例组患儿术前和术后的WBC、N%、L%、MO%、EO%、BA%、N#、L#、MO#、EO#、BA#、HCT、RDW-CV、PLT、PCT、PDW、P-LCR差异无统计学意义(P＞0.05)；术后RBC、HGB、MCH、MCHC、MPV较术前降低，差异具有统计学意义(P＜0.05)；MCV、RDW-SD较术前升高，差异具有统计学意义(P＜0.05)。结论 血常规指标可作为辅助评估SDB的病情严重程度和治疗效果的简便、可靠的实验室参考依据。

Abstract:

Objective To analyze the clinical significance of changes in blood routine indexes in children with sleep-disordered breathing (SDB) with adenoid and/or tonsil hypertrophy (ATH), so as to provide certain scientific basis for the assessment of the condition and prognosis of SDB in children. Methods Sixty children diagnosed with SDB (accompanied by ATH) who were hospitalized in the Department of Otorhinolaryngology of the First Affiliated Hospital of Dali University from October 2023 to August 2024 were selected as the case group, and 60 healthy children who had a physical examination in the hospital during the same period were selected as the control group. The children in the case group underwent adenoidectomy and/or tonsillectomy, and returned to the hospital for follow-up examination 3 months after the operation.The changes in blood routine indexes were compared between SDB children and healthy children, as well as between SDB children before and after surgery, respectively. Results The differences in the white blood cell count (WBC), neutrophil percentage (N%), lymphocyte percentage (L%), monocyte percentage (MO%), eosinophil percentage (EO%), basophil percentage (BA%), neutrophil count (N#), lymphocyte count (L#), monocyte count (MO#), eosinophil count (EO#), basophil count (BA#), red blood cell count (RBC), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red blood cell distribution width (RDW) (including coefficient of variation RDW-CV and standard deviation RDW-SD), platelet count (PLT), and platelet distribution width (PCT) between the case group and the control group were statistically insignificant (P>0.05). The mean platelet volume (MPV), platelet distribution width (PDW), platelet-large cell ratio (P-LCR) in the case group were all higher than those in the control group, and the differences were statistically significant (P<0.05). In the case group, MPV, PDW, and P-LCR were all positively correlated with age (r=0.322, P<0.05; r=0.376, P<0.05; r=0.349, P<0.05). The differences in WBC, N%, L%, MO%, EO%, BA%, N#, L#, MO#, EO#, BA#, HCT, RDW-CV, PLT, PCT, PDW, and P-LCR between preoperative and postoperative periods of the case group were not statistically significant (P>0.05); postoperative RBC, HGB, MCH, MCHC, and MPV were lower than those before surgery, and the differences were statistically significant (P<0.05); MCV and RDW-SD were higher than those before surgery, and the differences were also statistically significant (P<0.05). Conclusion Blood routine can serve as a simple and reliable laboratory parameter to assist in assessing the severity of SDB and evaluating the therapeutic effect.