【摘要】 目的观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血小板衍生生长因子(PDGF)水平的变化,探讨其与OSAHS及心血管疾病的关系。方法采用酶联免疫吸附试验(ELISA)检测2004年6月至2005年6月就诊的40例OSAHS患者和20例健康对照者外周血血清中血小板衍生生长因子-BB(PDGF-BB)水平,用逆转录聚合酶链反应(RT-PCR)技术检测受试者外周血单个核细胞PDGF-B mRNA水平,同时观察18例重度OSAHS患者经鼻持续气道正压通气(nCPAP)治疗前后相关指标的变化。结果OSAHS患者各组与对照组血清PDGF-BB水平[OSAHS轻、中、重组与对照组分别为(477±115)、(736±126)、(1 046±137)、(151±19)ng／L]及外周血单个核细胞PDGF-B mRNA水平[OSAHS轻、中、重组与对照组分别为(0．7±0．1)、(1．0±0．2)、(1．3±0．2)、(0．4±0．1)灰度面积比值]比较差异有统计学意义(F=102．59、58．75,P均<0．01);进一步分析与患者平均动脉压、睡眠呼吸暂停低通气指数(AHI)、小于90％脉搏容积血氧饱和度(SpO2)时间占总睡眠时间百分比、呼吸暂停时间占总睡眠时间百分比呈正相关(r值分别为0．657、0．682、0．683和0．551,P均<0．05),与平均SpO2、最低SpO2呈负相关(r值分别为-0．583及-0．576,P均<0．05)。经nCPAP治疗后,重度OSAHS患者血清PDGF-BB水平及外周血单个核细胞PDGF-B mRNA水平明显降低[治疗前分别为(1 046±137)ng／L、(1．3±0．2)灰度面积比值,治疗后分别为(699±130) ng／L、(0．7±0．2)灰度面积比值],但仍高于对照组[(151±19)ng/L、(0．4±0．1)灰度面积比值],差异有统计学意义(F=82．21、154．24,P均<0．01)。结论OSAHS患者PDGF水平明显增加,PDGF可能参与了OSAHS的病理过程,特别是OSAHS引发心血管疾病的相关病理生理过程。更多还原

【Abstract】 Objective To observe the change of platelet derived growth factor-B ( PDGF-B) in obstructive sleep apnea-hypopnea syndrome(OSAHS) patients,and to explore the relationship of PDCF-BB, OSAHS and complicated cardiovascular diseases. Methods The levels of serum PDGF-BB in 40 OSAHS patients and 20 healthy controls were measured by enzyme-linked immunosorbent assay ( ELISA) method. The levels of PDGF-B mRNA in peripheral blood mononuclear cells were measured by reverse transcription polymerase chain reaction ( RT-PCR). Results The serum levels of PDGF-BB and the levels of PDGF-B mRNA in peripheral blood mononuclear cells were significantly higher in OSAHS group [ mild, moderate, severe level was (477±115) ,(736±126) , (1 046±137)ng/L,and (0. 7±0. 1) , (1. 0±0. 2), (1. 3±0.2) respectively] than those in control group[(151±19)ng/L,0.4±0. 1 ,F = 102. 59,58. 75,P<0. 01 ] and PDGF-BB related with severity of OSAHS. There was a positive correlation between PDGF-BB level and AHI as well as average angiosthenia (P < 0. 05 ). Also, there was a positive correlation between PDGF-BB level and percentage of time spent when oxygen staturation lower than 90% ( SLT90% ) ( P < 0. 05). There was a negative correlation between PDGF-BB and average saturation of blood oxygen as well as lowest saturation of blood oxygen( P < 0.05). After nCPAP, The levels of PDGF and PDGF-B mRNA in OSAHS patients [before treatment: (1 046±137) ng/L, ( 1. 3±0.2) .after treatment: ( 699±130) ng/L, (0. 7±0.2)] reduced significantly,but still higher then those of control group[(151±19)ng/L,0.4±0. 1,F = 82. 21,154. 24 ,P < 0.01 ]. Conclusion The level of PDGF-BB in OSAHS is increased increases, which may play a role in the pathophysiology of OSAHS and complicated cardiovascular diseases.更多还原