【摘要】 目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆 IL-18水平与动脉粥样硬化的关系。方法选取就诊的男性 OSAHS 患者52例,年龄26～77岁,分为轻度组16例,中度组18例,重度组18例,另选对照组18例。对其中 OSAHS 组中20例中重度患者进行持续气道内正压(CPAP)治疗,并检测颈动脉内膜中膜厚度(IMT),测定血浆白细胞介素-18(IL-18)的水平。采用方差分析、配对 t 检验及 Pearson 相关分析进行统计学处理。结果轻度、中度和重度 OSAHS 组的 IL-18水平分别为(352±76)ng/L、(600±84)ng/L 和(798±110)ng/L,均明显高于对照组的(250±76)ng/L,且 OSAHS 各组间均有明显差别。重度 OSAHS 组颈动脉 IMT 较对照组和轻度 OSAHS 组明显增厚。血浆 IL-18水平与颈动脉 IMT、呼吸暂停低通气指数(AHI)呈显著正相关(r 值分别为0.486、0.865,P 均<0.001),与最低脉搏氧饱和度呈显著负相关(r=-0.664,P<0.001)。CPAP 治疗后OSAHS 患者血浆 IL-18水平明显降低,颈动脉 IMT 未见明显改变。结论 OSAHS 患者颈动脉 IMT 增厚,血浆 IL-18水平升高,两者密切相关。血浆 IL-18水平升高与 OSAHS 严重程度相关,OSAHS 相关炎症反应可能与动脉粥样硬化的进程相关。CPAP 治疗能够改善患者 AHI 和最低脉搏氧饱和度,降低血浆 IL-18水平。更多还原

【Abstract】 Objective To investigate the association between plasma interleukin-18（IL-18）levels and atherosclerosis in patients with obstructive obstructive sleep apnea hypopnea syndrome（OSAHS）. Methods Based on apnea hypopnea index（AHI）during sleep monitored by polysomnography,52 male patients with OSAHS were recruited and divided into a mild OSAHS group（n=16）,a moderate group（n= 18）,and a severe group（n=18）.Eighteen healthy subjects were selected as the control group.Twenty patients with moderate-to-severe OSAHS underwent continuous positive airway pressure（CPAP）treatment. HDL5000 color Doppler ultrasound was used to measure intima-media thickness（IMT）of the jugular arteries.Plasma IL-18 levels were measured by ELISA.Analysis of variance,paired-samples T test and Pearson correlation analysis were used for statistics.Results Compared with the plasma IL-18 levels in the control group[（250±76）ng/L],there was a significant increase in the mild OSAHS group[（352±76） ng/L],moderate group[（600±84）ng/L],and severe OSAHS group[（798±110）ng/L（all P< 0.01）].Moreover,there was a significant difference in plasma IL-18 levels among three OSAHS groups （P<0.01）.The jugular arterial IMT was significantly greater in severe OSAHS group than that in mild OSAHS group（P<0.01）.The plasma IL-18 levels were positively correlated with jugular arterial IMT（r= 0.486,P<0.001）and with AHI（r=0.865,P<0.001）respectively.After CPAP treatment,plasma IL-18 levels were significantly decreased but the jugular arterial IMT did not change significantly.Conclusion Our study demonstrated that jugular arterial IMT and plasma IL-18 levels were significantly increased and closely correlated.The elevation of plasma IL-18 levels was correlated with the severity（AHI and miniSaO₂）of OSAHS.更多还原