阻塞性睡眠呼吸暂停低通气综合征患者血清胱蛋白酶抑制剂C水平及尿系列酶活性的变化  

Changes of serum cystatin C level and serial urinary enzymes in patiens with obstructive sleep apnea hypopnea syndrome

作　　者：李莉[1] 余勤[1] 

机构地区：[1]兰州大学第一医院呼吸内科

出　　处：《中国呼吸与危重监护杂志》2006年第5期366-369,356,共5页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清胱蛋白酶抑制剂C(CystatinC)水平及尿系列酶活性的变化。方法选择OSAHS患者30例(OSAHS组)和健康成人30例(对照组),所有受试者均接受多导睡眠仪监测,采用ELISA法测定血清CystatinC水平,底物速率法检测尿系列酶N-乙酰-β-D氨基葡萄糖苷酶(NAG)、β-半乳糖苷酶(GAL)、γ-谷氨酰转移酶(GGT)和碱性磷酸酶(ALP)的活性。结果OSAHS组血清CystatinC水平显著高于对照组[(1.69±0.46)mg/L比(1.03±0.28)mg/L,P<0.01],尿系列酶NAG、GAL、GGT和ALP活性较对照组显著升高[分别为(5.02±2.11)U/(mmolCr)比(2.25±1.12)U/(mmolCr)、(1.42±0.57)U/(mmolCr)比(0.65±0.32)U/(mmolCr)、(3.78±0.70)U/(mmolCr)比(3.38±0.45)U/(mmolCr)、(0.81±0.28)U/(mmolCr)比(0.61±0.16)U/(mmolCr),P<0.01或P<0.05]。OSAHS组血清CystatinC水平与呼吸暂停低通气指数(AHI)呈正相关(r=0.538,P<0.01),与最低血氧饱和度(LSaO2)呈负相关(r=-0.515,P<0.01);尿系列酶NAG、GGT与AHI呈正相关(r=0.477,r=0.435,P<0.01或P<0.05),尿系列酶NAG、GGT与LSaO2负相关(r=-0.431,r=-0.510,P<0.05或P<0.01)。结论OSAHS患者血清CystatinC水平及尿系列酶活性显著升高,提示OSAHS患者存在肾功能损害。Objective To explore the roles of cystatin C level and serial urinary enzymes in patients with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods Polysomnography was performed in 30 OSAHS patients （OSAHS group） and 30 normal healthy adults （control group）. The level of serum cystatin C was determined by ELISA, and serial urinary enzymes [N-acetylglucosaminidase （NAG）, galactosidae （GAL）,γ-glutamyhransferase （GGT）, alkaline phosphatase （ALP） ] were detected by rate assay. Results The level of serum cystatin C in OSAHS group was significantly higher than that in the control group [ （ 1.69 ± 0.46）mg/L vs （1.03± 0.28）mg/L, P 〈 0.01]. In patients with OSAHS, the levels of NAG, GAL, GGT and ALP were significantly higher than those in the control group [（5.02 ± 2.11）U/（mmol Cr） vs （2.25± 1.12）U/（mmol Cr）, P〈 0.01; （1.42± 0. 57 ） U/（ mmol Cr） vs （0.65 ± 0. 32 ） U/（ mmol Cr）, P 〈 0.01; （3.78± 0.70）U/（mmol Cr） vs （3.38 ± 0.45）U/（mmol Cr）, P 〈 0.05; （0.81 ± 0.28）U/（mmol Cr） vs （0.61 ± 0.16）U/（mmol Cr）, P 〈 0.01 ; respectively]. In patients with OSAHS, the level of serum cystatin C was positively correlated with apnea hyponea index （AHI） （r = 0.538, P 〈 0.01 ） and negatively correlated with low level of SaO2（LSaO2） （ r = - 0.515, P 〈 0.01 ）. Levels of NAG and GGT were positively correlated with AHI （ r = 0. 477, P 〈 0.01 ; r = 0. 435, P 〈 0.05 ）, and levels of NAG and GGT were negatively correlated with LSaO2（r= -0.431, P〈0.05; r= -0.510, P〈0.01）. Conclusion The levels of serum cystatin C and serial urinary enzymes in OSAHS patients are increased, which suggest that the renal function is impaired in patients with OSAHS.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 胱蛋白酶抑制剂C 尿系列酶 肾功能 

分 类 号：R766[医药卫生—耳鼻咽喉科]