基于石墨烯的发热鼻罩联合糠酸莫米松鼻喷剂和孟鲁司特钠在儿童OSAHS治疗中的作用

Efficacy of graphene-based heated nasal mask combined with mometasone furoate nasal spray and montelukast in the treatment of pediatric obstructive sleep apnea-hypopnea syndrome

摘要

目的 探究基于石墨烯的发热鼻罩联合糠酸莫米松鼻喷剂和孟鲁司特钠治疗在儿童阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome, OSAHS)中的临床价值。方法 纳入单纯腺样体肥大致OSAHS的患儿100例，随机分为对照组(50例)、观察组(50例)。对照组患儿给予糠酸莫米松鼻喷剂和孟鲁司特钠进行治疗，观察组在对照组基础上使用石墨烯发热鼻罩进行治疗。观察并比较两组患儿治疗后效果、睡眠呼吸指标、血清炎症因子水平、睡眠生活质量相关指标。结果 观察组治疗总有效率较对照组高，差异有统计学意义(P=0.021)；与对照组相比，观察组患儿治疗后阻塞性呼吸暂停指数(obstructive apnea index, OAI)、呼吸暂停低通气指数(apnea-hypopnea index, AHI)、氧减指数(oxygen desaturation index, ODI)指数更低，但最低血氧饱和度(lowest arterial oxygen saturation, LSaO₂)更高(P<0.05)；血清IL-6、C反应蛋白(c-reactive protein, CRP)和TNF-α水差异有统计学意义(P<0.05)；匹兹堡睡眠质量指数(pittsburgh sleep quality index, PSQI)评分和OSA-18总分更低，差异有统计学意义(P<0.05)，而实际睡眠时长更长(P<0.05)。按患儿肥胖程度分层分析结果显示，两组治疗前、后睡眠呼吸指标、睡眠生活质量变化幅度和血清炎症因子水平下降幅度在肥胖患儿中都较在正常体质量患儿中小。结论 基于石墨烯的发热鼻罩联合糠酸莫米松鼻喷剂和孟鲁司特钠治疗单纯腺样体肥大致OSAHS患儿可减少临床症状，促进疗效提高，但在合并肥胖的OSAHS患儿中效果不显著，建议应结合膳食指导和体质量管理。

Abstract

Objective To investigate the clinical value of graphene-based heated nasal masks combined with mometasone furoate nasal spray and montelukast sodium in the treatment of pediatric obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods A total of 100 pediatric patients with OSAHS due to isolated adenoid hypertrophy were enrolled and randomly assigned to a control group (n=50) and an observation group (n=50). The control group received treatment with mometasone furoate nasal spray and montelukast sodium. The observation group received the same treatment regimen supplemented with graphene-based heated nasal masks. Treatment outcomes, sleep-disordered breathing parameters, serum inflammatory cytokine levels, and sleep-related quality of life indicators were observed and compared between the two groups. Results The overall response rate was higher in the observation group than in the control group, with a statistically significant difference as determined by a T-test (P=0.021). Compared with the control group, patients in the observation group exhibited lower obstructive apnea index (OAI), apnea-hypopnea index (AHI), and oxygen desaturation index (ODI) scores post-treatment, but higher lowest arterial oxygen saturation (LSaO₂) levels (P<0.05). Serum Interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-α) levels showed statistically significant differences (P<0.05). Scores of Pittsburgh sleep quality index (PSQI) and total scores of obstructive sleep apnea-18 survey (OSA-18) were significantly lower (P<0.05), while actual sleep duration was longer (P<0.05). Stratified analysis by obesity level indicated that, following the stratification based on obesity status, there were notable changes in indicators of sleep-disordered breathing, improvements in sleep quality, and reductions in serum inflammatory factor levels before and after treatment. were smaller in obese patients than in those with normal weight. Conclusion The combination of graphene-based heated nasal masks with mometasone furoate nasal spray and montelukast sodium for treating patients with simple adenoid hypertrophy complicated by OSAHS can reduce clinical symptoms and enhance the therapeutic efficacy. However, this approach shows no significant effect in obese pediatric patients with OSAHS. It is recommended to incorporate dietary guidance and weight management into the treatment regimen.

关键词

阻塞性睡眠呼吸暂停低通气综合征 / 儿童 / 石墨烯 / 肥胖 / 腺样体肥大

Key words

Obstructive sleep apnea hypopnea syndrome / Children / Graphene / Obesity / Adenoid hypertrophy

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基金资助

河北省卫生健康委科研基金项目(20241587)