摘要
目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清白细胞介素-18 (IL-18)与低氧诱导因子(HIF-1α)的水平变化及临床意义。方法选取2016年10月～2017年8月期间在潍坊市中医院确诊的89例OSAHS患者和62例健康体检者,对其一般临床资料、睡眠呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSpO2)进行比较分析。根据AHI划分为轻度OSAHS组30例、中度OSAHS组36例和重度OSAHS组23例。对OSAHS患者(AHI> 15次/h)采取持续气道正压通气(CPAP)的治疗方式,疗程3个月。患者每晚进行呼吸机持续正压通气治疗时间达到4 h,开始统计呼吸机持续正压通气治疗时间。采用多导睡眠采集分析系统对患者睡眠状态进行连续7 h监测,获得AHI与LSpO2数据。完成后,凌晨6时在患者空腹的情况下抽取静脉血(开始治疗的前1天和治疗结束前1天)。采用酶联免疫吸附法(ELISA)测定血清IL-18与HIF-1α水平。用多元线性回归分析来分析可能影响IL-18与HIF-1α水平的因素,包括年龄、性别、体质量指数(BMI)、AHI和LSpO2等。结果与健康对照组相比,OSAHS组患者血清IL-18与HIF-1α水平较高,且差异有统计学意义(P <0.05)。血清IL-18与HIF-1α水平随着OSAHS严重程度的增加而升高。多元线性回归分析显示,年龄、AHI和LSpO2是影响IL-18水平的危险因素,AHI和LSpO2是影响HIF-1α的危险因素。OSAHS患者接受CPAP治疗后,血清IL-18与HIF-1α水平显著降低(59.80 vs. 45.94,36.56 vs.21.97,P <0.01)。结论血清IL-18和HIF-1α水平的变化可间接地反映OSAHS和缺氧的严重程度及干预治疗的有效性。
Objective To investigate the clinical value of serum Il-18 and HIF-1αin patients with obstructive sleep apnea-hypopnea syndromes(OSAHS).Methods 89 OSAHS patients and 62 healthy individuals were enrolled during October 2016 and August 2017.The basic clinical information,lowest arterial oxygen saturation(LSpO2)and apnea-hypopnea index(AHI)were determined and compared.The patients were classified into mild,moderate,and severe OSAHS groups according to AHI.The subjects(AHI>15 times/h)were provided with continuous positive airway pressure(CPAP)therapy,and the time of CPAP treatment was 4h for every night.Before and after CPAP treatment for 3 months,polysomnography acquisition and analysis system was used to continuously detect the sleep status of subjects for 7 hours and then data of AHI and LSpO2 were recorded,then venous blood was collected from each subject on the next morning Serum level of IL-18 and HIF-1αwere detected with enzyme-linked immunosorbent assay(ELISA)method.Multiple linear regression analysis was conducted to analyze the possible influencing factors,including age,sex,BMI,AHI and LSpO2.Results Compared with healthy control group,serum level of HIF-1αand IL-18 in OSAHS patients were much higher(P<0.05).In addition,serum level of IL-18 and HIF-1αwere increased as the severity of OSAHS.Multiple linear regression analysis indicated that age,AHI and LSpO2 affected the level of IL-18;AHI and LSpO2 served as risk factors for HIF-1α.After CPAP therapy,serum level of IL-18 and HIF-1αof OSHAS patients were remarkably reduced(59.80 vs 45.94;36.56 vs 21.97).Conclusion Abnormal levels of IL-18 and HIF-1αmay indirectly reflect the serious degree of OSAHS and hypoxia,and the effectiveness of intervention treatment.
作者
张凤英
牛金明
杨树芹
葛洪洲
程莉雅
吴美美
吕艳春
Zhang Fengying;Niu Jinming;Yang Shuqin(Department of Otolaryngology,Weifang Traditional Chinese Hospital,Weifang 261041,China)
出处
《中华保健医学杂志》
2019年第1期9-12,共4页
Chinese Journal of Health Care and Medicine
基金
潍坊市科技局资助项目(2017YX012)
