摘要
目的探讨肿瘤坏死因子α(TNF-α)与金属酶蛋白-9(MMP-9)在共存中-重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的缺血性脑血管病人外周血中的水平及运用经鼻持续正压通气(n CPAP)治疗后其水平变化,并随访观察其缺血性脑血管病(ICVD)的再发生情况。方法选择2010年2月至2013年2月间在河北医科大学第二医院神经内科住院或门诊的缺血性脑血管病患者58例,20例体检正常者作为对照组。检测其外周血中TNF-α与MMP-9含量。应用Apnea Link TM仪器对缺血性脑血管病患者进行监测,给予其中29例共存中-重度OSAHS的缺血性脑血管病组患者n CPAP治疗3个月后再次检测上述指标,并长期随访观察患者ICVD再发情况。结果共存中-重度OSAHS缺血性脑血管病组MMP-9水平明显高于非OSAHS组及对照组,运用n CPAP治疗后其水平明显下降,尤其在运用n CPAP 3个月内ICVD再发例数明显下降。结论缺血性脑血管病存在炎症反应,而OSAHS可加重其炎性反应,诱发或加重缺血性脑血管病再发生。运用n CPAP治疗中-重度OSAHS的缺血性脑血管病患者,可降低其外周血MMP-9的水平,降低ICVD再发。
Objective To investigate the levels of TNF-αand MMP-9 in moderate to severe obstructive sleep apnea hypopnea syndrome （ OSAHS ） with ischemic cerebrovascular disease in human peripheral blood and the changes of serum MMP-9, TNF-αin OSAHS patients with ischemic cerebrovascular disease （ ICVD ） by nasal continuous positive airway pressure（nCPAP）treatment.In the same time,to follow-up ICVD reoccurrence.Methods All cases of 58 patients with ICVD were treated in wards and outpatient of the department of neurology which was collected from February 2010 to February 2013 in Second Hospital of Hebei Medical University.Normal control group：over the same period to the examination center of our hospital healthy people of normal physical examination, no significant history of snoring in 20 cases.ApneaLinkTM was performed in these ICVD patients to identify whether they were complicated by OSAHS.After nCPAP therapy of 3 month,the venous blood of the 29 ischemic cerebrovascular disease patients with moderate to severe OSAHS were collected at the next morning.Results MMP-9 levels of moderate to severe OSAHS with ICVD group was significantly higher than the non-OSAHS group and the control group.In particular,the recurrence of ICVD decreased significantly with nCPAP in 3 months.Conclusion ICVD patients have a pro-inflammatory state, while OSAHS may exacerbate the inflammatory response of brain disease, induce or aggravate ICVD.nCPAP significantly decrease the levels of MMP-9 in the ICVD patients with moderate to severe OSAHS.
出处
《脑与神经疾病杂志》
2015年第2期126-129,共4页
Journal of Brain and Nervous Diseases
基金
2010年国际睡眠呼吸暂停综合症协作组子课题
关键词
缺血性脑血管病
阻塞性睡眠呼吸暂停低通气综合征
鼻持续正压通气
炎性因子
Ischemic cerebrovascular disease
Obstructive sleep apnea hypopnea sydrome
Nasal continous positive airway pressure
Inflammatory cytokines
