【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TNF-α水平的变化,以及CPAP治疗的影响和临床意义。方法:48例多导睡眠图确诊的男性OSAHS患者,按照呼吸暂停低通气指数(AHI)分为轻度OSAHS组(n=15),中度OSAHS组(n=16),重度OSAHS组(n=17)。16例年龄和体重指数(BMI)匹配的健康男性作为对照组,其中13例中重度OSAHS患者进行持续气道正压通气(CPAP)治疗。ELISA法测定血浆TNF-α浓度。对OSAHS患者血浆TNF-α与睡眠期AHI和最低脉氧饱和度(miniSpO2)进行Pearson相关性分析。结果:轻度、中度和重度OSAHS组TNF-α浓度分别为(11.49±1.32pg/ml)、(13.29±1.73pg/ml)、(14.74±2.72pg/ml),均显著高于正常对照组(9.29±1.74pg/ml)。TNF-α水平随OSAHS程度加重而增高。Pearson相关性分析显示OSAHS患者TNF-α浓度与呼吸暂停低通气指数(AHI)呈显著正相关(r=0.714,P<0.001),与miniSpO2间呈显著负相关(r=-0.601,P<0.001)。CPAP治疗后OSAHS患者血浆TNF-α水平显著降低(P<0.001)。结论:CPAP治疗可降低或防止OSAHS患者的动脉硬化进展。更多还原

【Abstract】 Objective: To investigate the plasma tumor necrosis factor-α (TNF-α) levels and the effects of continuous positive airway pressure (CPAP) treatment on plasma TNF-α levels in OSAHS patients. Methods: 48 male patients with OSAHS were recruited and divided into mild OSAHS group (n=16), moderate OSAHS group(n=15) and severe OSAHS group(n=17). 16 healthy male with matched age and BMI were selected as control group. 13 patients with moderate-to-severe OSAHS underwent continuous positive airway pressure (CPAP) treatment for 90 days. The levels of Plasma TNF-α were measured by ELISA. Correlation of TNF-α with AHI and minimal pulse oxygen saturation (miniSpO2) were analyzed in OSAHS patients. Results: Compared with control group (9.29±1.74 pg/ml), there were significant increase in mild group (11.49±1.32 pg/ml), moderate group (13.29±1.73 pg/ml), and severe group (14.74±2.72 pg/ml) (P<0.001). Moreover, there were significant differences in TNF-α level among three OSAHS groups. As the degrees of OSAHS become more severe, TNF-α level became higher. Pearson analysis indicated that TNF-α level were positively correlated with AHI(r=0.714, P<0. 001), but were negatively correlated with miniSpO2(r=-0.601, P<0.001). After day 90 of CPAP treatment, plasma IL-18 levels were strikingly declined (P<0.001). Conclusion: CPAP treatment may in a long run slow down or prevent the development of AS in OSAHS patients.更多还原