目的 探討OSAHS 患者血清炎癥因子檢測(cè)的臨床意義。方法 OSAHS 患者40 例和正常對(duì)照30 例, 采用酶聯(lián)免疫技術(shù)檢測(cè)血清8-異前列烷( 8-isoPG) 、白三烯B4 ( LTB4 ) 、TNF-α、IL-10水平, 以全自動(dòng)生化分析儀測(cè)定高敏C 反應(yīng)蛋白( Hs-CRP) 的濃度, 并與睡眠監(jiān)測(cè)指標(biāo)進(jìn)行相關(guān)性分析。其中20 例OSAHS 患者分別經(jīng)自動(dòng)持續(xù)氣道正壓通氣( Auto-CPAP) 或懸雍垂軟腭咽成形術(shù)( UPPP) 治療3 個(gè)月后, 復(fù)查睡眠呼吸監(jiān)測(cè)和上述炎癥因子。結(jié)果 ①OSAHS 組睡眠后血清中8-isoPG、LTB4、TNF-α、IL-10 和Hs-CRP 分別為( 36.59 ±14. 89 ) ng /L、( 14. 75 ±6. 25 ) μg/L、( 1022. 13 ±97. 57) ng /L、( 4. 68 ±3. 42) ng/L 和( 2.46 ±1. 58) mg/L, 正常對(duì)照組分別為( 19. 91 ±7. 76) ng/L、( 1. 43 ±0. 72) μg/L、( 540.00 ±78. 70) ng /L、( 7.41 ±4. 49 ) ng/L 和( 0. 30 ±0. 16) mg/L, 兩組比較差異均有統(tǒng)計(jì)學(xué)意義( P 均 lt;0. 01) 。②OSAHS 組血清中8-isoPG、LTB4、TNF-α和Hs-CRP隨病情嚴(yán)重度增高而升高, IL-10 隨病情嚴(yán)重度增高而降低( P 均 lt; 0. 05) 。③OSAHS 患者睡眠后血清中8-isoPG、LTB4、TNF-α、Hs-CRP 與呼吸暫停低通氣指數(shù)( AHI) 呈正相關(guān)( r 值分別為0. 863, 0. 746, 0. 868 和0. 842, P 均 lt;0. 01) ; 與睡眠中最低血氧飽和度( LSpO2 ) 呈負(fù)相關(guān)( r 值分別為- 0. 623, - 0. 524, - 0. 618 和- 0. 562, P 均 lt;0. 01) ; 與平均血氧飽和度( MSpO2 ) 呈負(fù)相關(guān)( r 值分別為- 0. 654, - 0. 573, - 0. 537 和- 0. 589, P 均 lt;0. 01) ; OSAHS患者睡眠后血清中IL-10與AHI 呈負(fù)相關(guān)( r = - 0. 722, P lt;0. 01) , 與睡眠中LSpO2 呈正相關(guān)( r = 0. 564, P lt; 0. 01) , 與MSpO2 呈正相關(guān)( r =0. 505, P lt;0. 01) 。④20 例OSAHS 患者經(jīng)治療3 個(gè)月后血清8-isoPG、LTB4 、TNF-α及Hs-CRP 均較治療前下降, 血清中IL-10 比治療前上升( P lt;0. 01) 。⑤OSAHS 患者治療后血清8-isoPG、IL-10 與正常對(duì)照組比較無(wú)顯著差異( P gt; 0. 05) , 血清LTB4、TNF-α和Hs-CRP 比正常對(duì)照組水平高( P lt; 0. 01) 。結(jié)論 OSAHS 患者存在夜間低氧后炎癥反應(yīng)及氧化應(yīng)激增強(qiáng), 抗炎因子水平降低。炎癥因子檢測(cè)結(jié)合睡眠呼吸監(jiān)測(cè)對(duì)判斷OSAHS 嚴(yán)重程度和治療效果具有一定的臨床意義。
引用本文： 夏秋萍,陳建榮,蔡映云,陶一江. 阻塞性睡眠呼吸暫停低通氣綜合征患者血清8-isoPG、LTB4、TNF-α、IL-10、Hs-CRP檢測(cè)的臨床意義. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2009, 09(3): 262-266. doi: 復(fù)制
| 1. | Carpagnano GE, Kharitonov SA, Resta O, et al.8-Isoprostane, a marker of oxidative stress, is increased in exhaled breath condensate of patients with obstructive sleep apnea after night and is reduced by continuous positive airway pressure therapy. Chest, 2003,124: 1386-1392. |
| 2. | 夏秋萍, 陳建榮, 蔡映云, 等. 阻塞性睡眠呼吸暫停綜合征呼出氣冷凝液中炎癥因子檢測(cè)的研究進(jìn)展. 國(guó)際呼吸雜志, 2008, 28:146-149. |
| 3. | Kageyama N, Nomura M, Nakaya Y, et al. Relationship between adhesion molecules with hs-CRP and changes therein after ARB ( Valsartan) administration in patients with obstructive sleep apnea syndrome. J Med Invest, 2006, 53: 134-139. |
| 4. | Riha RL, Brander P, Vennelle M, et al. Tumour necrosis factor-alpha ( -308) gene polymorphism in obstructive sleep apnoea-hypopnoea syndrome. Eur Respir J, 2005, 26: 673-678. |
| 5. | 陳金亮, 陳建榮, 陶一江, 等. 慢性阻塞性肺疾病患者呼出氣冷凝液中白細(xì)胞三烯B4 和腫瘤壞死因子-α的檢測(cè)及其臨床意義. 中國(guó)危重病急救醫(yī)學(xué), 2008, 20: 357-360. |
| 6. | Kheirandish L, Goldbart AD, Gozal D. Intranasal steroids and oral leukotriene modifier therapy in residual sleep-disordered breathing after tonsillectomy and adenoidectomy in children. Pediatrics, 2006 ,117: e61-e66. |
| 7. | Ryan S, Taylor CT, McNicholas WT. Predictors of elevated nuclear factor-kappaB-dependent genes in obstructive sleep apnea syndrome.Am J Respir Crit Care Med, 2006, 174: 824-830. |
| 8. | 黃燕, 林勇. 阻塞性睡眠呼吸暫停低通氣綜合征患者血清脂聯(lián)素水平的變化. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2006, 5: 125-128. |
- 1. Carpagnano GE, Kharitonov SA, Resta O, et al.8-Isoprostane, a marker of oxidative stress, is increased in exhaled breath condensate of patients with obstructive sleep apnea after night and is reduced by continuous positive airway pressure therapy. Chest, 2003,124: 1386-1392.
- 2. 夏秋萍, 陳建榮, 蔡映云, 等. 阻塞性睡眠呼吸暫停綜合征呼出氣冷凝液中炎癥因子檢測(cè)的研究進(jìn)展. 國(guó)際呼吸雜志, 2008, 28:146-149.
- 3. Kageyama N, Nomura M, Nakaya Y, et al. Relationship between adhesion molecules with hs-CRP and changes therein after ARB ( Valsartan) administration in patients with obstructive sleep apnea syndrome. J Med Invest, 2006, 53: 134-139.
- 4. Riha RL, Brander P, Vennelle M, et al. Tumour necrosis factor-alpha ( -308) gene polymorphism in obstructive sleep apnoea-hypopnoea syndrome. Eur Respir J, 2005, 26: 673-678.
- 5. 陳金亮, 陳建榮, 陶一江, 等. 慢性阻塞性肺疾病患者呼出氣冷凝液中白細(xì)胞三烯B4 和腫瘤壞死因子-α的檢測(cè)及其臨床意義. 中國(guó)危重病急救醫(yī)學(xué), 2008, 20: 357-360.
- 6. Kheirandish L, Goldbart AD, Gozal D. Intranasal steroids and oral leukotriene modifier therapy in residual sleep-disordered breathing after tonsillectomy and adenoidectomy in children. Pediatrics, 2006 ,117: e61-e66.
- 7. Ryan S, Taylor CT, McNicholas WT. Predictors of elevated nuclear factor-kappaB-dependent genes in obstructive sleep apnea syndrome.Am J Respir Crit Care Med, 2006, 174: 824-830.
- 8. 黃燕, 林勇. 阻塞性睡眠呼吸暫停低通氣綜合征患者血清脂聯(lián)素水平的變化. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2006, 5: 125-128.