摘要
目的通过检测孕产妇血清中炎症因子(IL-6和TNF-α),探讨睡眠呼吸暂停低通气综合征(SAHS)与子痫前期疾病发生和发展的相关性及其可能的发病机制。方法选取子痫前期合并SAHS孕妇27例、子痫前期无SAHS孕妇43例和同期入院产检的正常孕妇25例,所有入选者均已进行整晚的多导睡眠监测(PSG),记录呼吸暂停低通气指数(AHI)和最低血氧饱和度(LSaO2),并同时记录年龄、孕龄、体质量指数(BMI)、平均动脉压(MAP)和24 h尿蛋白定量值。结果 3组间年龄、孕龄无显著差异,正常组与其余两组比较BMI有显著差异,但子痫前期无SAHS组与子痫前期并SAHS组无显著差异,正常组与子痫前期无SAHS组AHI和LSaO2\无显著差异,3组间MAP、24 h尿蛋白定量值、IL-6和TNF-α均有显著差异。相关性分析提示MAP和24 h尿蛋白定量值及炎症因子指标与AHI呈明显正相关,与LSaO2负相关,其中各指标与BMI也呈明显相关性,但相关性较弱。结论 SAHS可能是子痫前期疾病发生和发展的一个危险因素,其中炎症因子IL-6和TNF-α在中间起重要的桥梁作用。另外对于肥胖的孕妇应给予更多的关注,但肥胖不是主要因素,及时诊断是否存在SAHS并给予相关的治疗以避免因SAHS可能导致的子痫前期的发生和发展。
Objective To investigate the relationship between sleep apnea-hypopnea syndrome（SAHS） and preeclampsia and the possible pathogenesis of the latter.Methods Twenty-five healthy pregnant women,43 pregnant women with preeclampsia,and 27 with preeclampsia complicated by SAHS were enrolled in this study.Apnea-hypopnea index（AHI） and the lowest arterial oxygen saturation（LSaO2） were measured through a 7-hour polysomnography（PSG）,and the maternal age,gestational age,body mass index and 24-hour urine protein were recorded.Results All the indexes except for the maternal age and gestational age showed significant differences between the 3 groups.The two groups of preeclampsia patients showed a significant difference in BMI from the control cases.Significant positive correlations of AHI to BMI,MAP and 24-hour urine protein were noted;LSaO2 was found to inversely correlate to BMI,MAP,and 24-hour urine protein.In spite of the significant correlation of BMI to the other indexes,we found that BMI was less important than AHI and LSaO2.Conclusion SAHS may induce or aggravate preeclampsia.Greater attention should be given to the presence of SAHS in pregnant women with obesity,but obesity is not the predominant predisposing factor for preeclampsia.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2010年第6期1366-1368,共3页
Journal of Southern Medical University
