【摘要】 目的探究阻塞性睡眠呼吸暂停综合征（OSAS）患者血清摄食抑制因子-1（Nesfatin-1）水平变化及临床意义。方法选取2016年6月～2017年6月于广东省韶关市粤北人民医院（以下简称"我院"）就诊的OSAS患者50例作为OSAS组,并根据呼吸暂停低通气指数（AHI）又分为轻度亚组10例、中度亚组24例、重度亚组16例;另选取同期于我院体检中心就诊的健康体检者30名作为对照组。比较OSAS组和对照组的血清Nesfatin-1水平、Epworth嗜睡量表（ESS）评分、AHI、最低血氧饱和度（LSaO₂）及最长呼吸暂停时间(T_max)。观察OSAS不同亚组的血清Nesfatin-1水平、ESS评分、LSaO₂及T_max。采用Pearson相关性分析ESS评分、AHI、T_max及LSaO₂与血清Nesfatin-1水平的相关性,采用受试者工作特征曲线（ROC）评价Nesfatin-1在OSAS中的诊断效能。结果 OSAS组的血清Nesfatin-1水平、ESS评分、AHI均显著高于对照组,LSaO₂显著低于对照组,T_max显著长于对照组（P<0.05）。轻度亚组、中度亚组、重度亚组的血清Nesfatin-1水平、ESS评分、T_max随病情程度加重而逐渐升高,LSaO₂随病情程度加重而逐渐降低（P<0.05）。OSAS组患者ESS评分、AHI、T_max均与血清Nesfatin-1水平呈正相关（r=0.711、0.621、0.357,均P<0.05）,LSaO₂与血清Nesfatin-1呈负相关（r=-0.477,P<0.05）。以血清Nesfatin-1≥4.8μg/L为诊断标准,诊断OSAS的敏感度为81.52%,特异度为76.17%。结论 OSAS患者血清Nesfatin-1水平存在异常升高,且升高程度与病情严重程度相关,对于临床诊疗具有指导意义。更多还原

【Abstract】 Objective To investigate the expression of serum Nesfatin-1 in patients with obstructive sleep apnea syndrome（OSAS）and its clinical significance.Methods Fifty patients with OSAS admitted to Yuebei People′s Hospital of Shaoguan City,（"our hospital"for short）from June 2016 to June 2017 were selected as OSAS group and divided into mild subgroup（10 cases）,moderate subgroup（24 cases）and severe subgroup（16 cases）according to apnea hypopnea index（AHI）.Another 30 healthy subjects visited the physical examination center of our hospital in the same period were selected as control group.Serum Nesfatin-1 level,Epworth sleepiness scale（ESS）score,AHI,minimum oxygen saturation（LSaO₂）and maximum apnea time(T_max)were compared between OSAS group and control group.Serum Nesfatin-1 level,ESS score,LSaO₂ and T_maxin different subgroups of OSAS were observed.Pearson correlation analysis was used to analyze the correlation between ESS score,AHI,T_maxand LSaO₂ and serum Nesfatin-1 level.Subject working characteristic curve（ROC）was used to evaluate the diagnostic efficacy of Nesfatin-1 in OSAS.Results Serum Nesfatin-1 level,ESS score and AHI in OSAS group were significantly higher than those in control group,LSaO₂ in OSASgroup was significantly lower than that in control group,and T_maxin OSAS group was significantly longer than that incontrol group（P<0.05）.Serum Nesfatin-1 level,ESSscore and T_maxin mild,moderate and severe subgroups increased with the severity of the disease,while LSaO₂ decreased with the severity of the disease（P<0.05）.ESS score,AHI and T_maxin OSAS group were positivelycorrelated with serum Nesfatin-1 level（r=0.711,0.621,0.357,all P<0.05）,and LSaO₂ was negatively correlated with serum Nesfatin-1（r=0.477,P<0.05）.The sensitivity and specificity of serum Nesfatin-1（≥4.8μg/L）for diagnosis of OSAS were 81.52% and 76.17%respectively.Conclusion The level of serum Nesfatin-1 in OSAS patients is abnormally elevated,and the degree of elevation is related to the severity of the disease,which has guiding significance for clinical diagnosis and treatment.更多还原