{"title":"上颌快速扩张对阻塞性睡眠呼吸暂停和上颌限制患儿尿白三烯E4和血清c反应蛋白水平的影响：一项前瞻性纵向研究","authors":"Sahal Alforaidi, Maen Zreaqat, Rozita Hassan","doi":"10.1002/ppul.71235","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Rapid maxillary expansion (RME) has been advocated as a viable treatment option in pediatric obstructive sleep apnea (OSA) due to its favorable effect in enhancing upper airway and respiratory parameters. This study aimed to evaluate the effect of RME on urine leukotriene E4 (uLTE4) and serum C-reactive protein (CRP) levels in OSA children with maxillary constriction and determine the association between alterations in uLTE4 and serum CRP levels and changes in dentoalveolar and respiratory parameters.</p><p><strong>Methods: </strong>This prospective longitudinal study comprised 47 children, aged 8-12 years, with polysomnography-proven OSA and maxillary constriction, who were treated with the RME appliance and matched with corresponding controls. uLTE4 and serum CRP levels were measured before and after treatment. A second standard overnight polysomnography (PSG) was conducted to assess changes in respiratory parameters.</p><p><strong>Results: </strong>Inter-molar width increased by 5.1 mm (p < 0.001). The RME resulted in a significant increase in the facial height and inferior dislocation of the maxilla (p < 0.05). Respiratory parameters changed significantly in the study group; sleep efficiency increased by 3.41% (p = 0.036), minimum oxygen saturation increased by 5.32% (p < 0.001), arousal index decreased by 7.46 events/h (p < 0.001), and apnea-hypopnea index (AHI) decreased by 3.53 events/h (p < 0.001). There was no significant difference in uLTE4 and serum CRP levels in the study or control group (p > 0.05). There was no association between the AHI and changes in uLTE4 and serum CRP levels after treatment (p > 0.05); however, a positive association was found with the intermolar width (p = 0.019).</p><p><strong>Conclusion: </strong>The treatment of pediatric OSA with the RME appliance did not affect uLTE4 or serum CRP levels, despite significant improvements in dentoalveolar features and respiratory sleep parameters.</p>","PeriodicalId":19932,"journal":{"name":"Pediatric Pulmonology","volume":"60 8","pages":"e71235"},"PeriodicalIF":2.3000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of Rapid Maxillary Expansion on Urinary Leukotriene E4 and Serum C-Reactive Protein Levels in Children With Obstructive Sleep Apnea and Maxillary Restriction: A Prospective Longitudinal Study.\",\"authors\":\"Sahal Alforaidi, Maen Zreaqat, Rozita Hassan\",\"doi\":\"10.1002/ppul.71235\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Rapid maxillary expansion (RME) has been advocated as a viable treatment option in pediatric obstructive sleep apnea (OSA) due to its favorable effect in enhancing upper airway and respiratory parameters. This study aimed to evaluate the effect of RME on urine leukotriene E4 (uLTE4) and serum C-reactive protein (CRP) levels in OSA children with maxillary constriction and determine the association between alterations in uLTE4 and serum CRP levels and changes in dentoalveolar and respiratory parameters.</p><p><strong>Methods: </strong>This prospective longitudinal study comprised 47 children, aged 8-12 years, with polysomnography-proven OSA and maxillary constriction, who were treated with the RME appliance and matched with corresponding controls. uLTE4 and serum CRP levels were measured before and after treatment. A second standard overnight polysomnography (PSG) was conducted to assess changes in respiratory parameters.</p><p><strong>Results: </strong>Inter-molar width increased by 5.1 mm (p < 0.001). The RME resulted in a significant increase in the facial height and inferior dislocation of the maxilla (p < 0.05). Respiratory parameters changed significantly in the study group; sleep efficiency increased by 3.41% (p = 0.036), minimum oxygen saturation increased by 5.32% (p < 0.001), arousal index decreased by 7.46 events/h (p < 0.001), and apnea-hypopnea index (AHI) decreased by 3.53 events/h (p < 0.001). There was no significant difference in uLTE4 and serum CRP levels in the study or control group (p > 0.05). There was no association between the AHI and changes in uLTE4 and serum CRP levels after treatment (p > 0.05); however, a positive association was found with the intermolar width (p = 0.019).</p><p><strong>Conclusion: </strong>The treatment of pediatric OSA with the RME appliance did not affect uLTE4 or serum CRP levels, despite significant improvements in dentoalveolar features and respiratory sleep parameters.</p>\",\"PeriodicalId\":19932,\"journal\":{\"name\":\"Pediatric Pulmonology\",\"volume\":\"60 8\",\"pages\":\"e71235\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Pulmonology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/ppul.71235\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Pulmonology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ppul.71235","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
摘要
快速上颌扩张术（RME）因其在改善上呼吸道和呼吸参数方面的良好作用而被提倡作为儿童阻塞性睡眠呼吸暂停（OSA）的可行治疗方案。本研究旨在评估RME对OSA合并上颌缩窄患儿尿白三烯E4 （uLTE4）和血清c反应蛋白（CRP）水平的影响，并确定uLTE4和血清CRP水平的改变与牙槽和呼吸参数的变化之间的关系。方法：这项前瞻性纵向研究包括47名8-12岁的儿童，患有多导睡眠图证实的OSA和上颌缩窄，他们使用RME器械治疗并与相应的对照组相匹配。治疗前后分别检测uLTE4和血清CRP水平。第二项标准夜间多导睡眠图（PSG）用于评估呼吸参数的变化。结果：磨牙间宽度增加5.1 mm （p < 0.05）。治疗后AHI与uLTE4和血清CRP水平变化无相关性（p < 0.05）；然而，与磨牙间宽度呈正相关（p = 0.019）。结论：使用RME器械治疗儿童OSA并不影响uLTE4或血清CRP水平，尽管牙槽特征和呼吸睡眠参数有显著改善。
Effects of Rapid Maxillary Expansion on Urinary Leukotriene E4 and Serum C-Reactive Protein Levels in Children With Obstructive Sleep Apnea and Maxillary Restriction: A Prospective Longitudinal Study.
Introduction: Rapid maxillary expansion (RME) has been advocated as a viable treatment option in pediatric obstructive sleep apnea (OSA) due to its favorable effect in enhancing upper airway and respiratory parameters. This study aimed to evaluate the effect of RME on urine leukotriene E4 (uLTE4) and serum C-reactive protein (CRP) levels in OSA children with maxillary constriction and determine the association between alterations in uLTE4 and serum CRP levels and changes in dentoalveolar and respiratory parameters.
Methods: This prospective longitudinal study comprised 47 children, aged 8-12 years, with polysomnography-proven OSA and maxillary constriction, who were treated with the RME appliance and matched with corresponding controls. uLTE4 and serum CRP levels were measured before and after treatment. A second standard overnight polysomnography (PSG) was conducted to assess changes in respiratory parameters.
Results: Inter-molar width increased by 5.1 mm (p < 0.001). The RME resulted in a significant increase in the facial height and inferior dislocation of the maxilla (p < 0.05). Respiratory parameters changed significantly in the study group; sleep efficiency increased by 3.41% (p = 0.036), minimum oxygen saturation increased by 5.32% (p < 0.001), arousal index decreased by 7.46 events/h (p < 0.001), and apnea-hypopnea index (AHI) decreased by 3.53 events/h (p < 0.001). There was no significant difference in uLTE4 and serum CRP levels in the study or control group (p > 0.05). There was no association between the AHI and changes in uLTE4 and serum CRP levels after treatment (p > 0.05); however, a positive association was found with the intermolar width (p = 0.019).
Conclusion: The treatment of pediatric OSA with the RME appliance did not affect uLTE4 or serum CRP levels, despite significant improvements in dentoalveolar features and respiratory sleep parameters.
期刊介绍：
Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases.
PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.
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