阻塞性睡眠呼吸暂停低通气综合征患者血清甲状腺素的研究  

Investigation of serum thyroxine in obstructive sleep apnea-hypopnea syndrome patients.

作　　者：何志红[1] 郭丽萍[2] 吴雅丽[2] 段争[2] 高英[1] 彭少舫 吴颂时 张敏[1] 

机构地区：[1]河北省石家庄市第一医院急诊科,050011 [2]河北医科大学第二医院呼吸科

出　　处：《中国综合临床》2009年第9期961-964,共4页Clinical Medicine of China

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者血清甲状腺素水平以及在OSAHS病情进展中的作用。方法选择OSAHS患者和健康者（对照组）各40例，均为男性，分别行多导睡眠图检查，并测定空腹甲状腺素水平。结果（1）OSAHS肥胖组的颈围为（43．56±3．48）cm，对照肥胖组为（38．33±3．08）cm，2组比较差异有统计学意义（t=4．258，P〈0．05）；OSAHS非肥胖组的颈围为（40．50±1．05）cm，对照非肥胖组为（36．17±3．13）cm，2组比较差异有统计学意义（t=3．146，P〈0．05）。OSAHS肥胖组的FT3水平为（6．35±3．15）μmol/L，对照肥胖组为（4．08±2．37）μmol/L，2组比较差异有统计学意义（t=2．203，P〈0．05）；OSAHS非肥胖组的嘎水平为（3．42±0．57）μmoVL，对照非肥胖组为（2．46±0．31）μmoVL，2组比较差异有统计学意义（t=2．187，P〈0．05）。（2）OSAHS患者FT3与低通气指数及微觉醒指数均呈正相关（r=0．500，P〈0．05；r=0．561，P〈0．05），FT4与微觉醒指数呈正相关（r=0．542，P〈0．05）。（3）OSAHS患者FT3与颈围呈正相关（r=0．489，P〈0．05），促甲状腺素与颈围呈负相关（r=-0．500，P〈0．05），促甲状腺素与脂肪百分比呈正相关（r=0．498，P〈0．05）。结论OSAHS患者FT3，浓度虽均在正常范围内，但明显高于对照组，提示OSAHS患者有出现代谢异常的趋势。同时FT3与颈围存在明显的相关性，提示OSAHS患者颈围的增加与甲状腺素相关。Objective To investigate the changes of serum thyroxine level in obstructive sleep apnea-hy- popnea syndrome（OSAHS）patients and to assess the role of serum thyroxine in the development of OSAHS. Methotis Polysomnography was used to examine the patients with OSAHS and fasting plasma serum thyroxine level were determined in 40 males with OSAHS and 40 males normal controls. Results （1）Neck circumference was significantly higher in obese OSAHS patients than in obese controls [ （43.56 ± 3.48 ）cm vs （38.33 ± 3.08 ）cm, t = 4.258, P 〈 0.05 ], in non-obese OSAHS patients than in non-obese control group [ （40.50 ± 1.05 ）cm vs （36.17 ± 3.13 ）cm, t =3. 146,P 〈0.05] . The levels of FT3 was （6.35 ±3.15） μmol/L in obese OSAHS patients and （ 4.08 ±2.37） pmol/L in control subjects （ t = 2. 203, P 〈 0.05 ）. That was （ 3.42 ± 0.57 ） μmoL/L in non-obese OSAHS patients and （2.46 ± 0.31 ） pmol/L in control subjects （ t = 2. 187 ,P 〈 0.05 ）. （2）In OSAHS group, FT3 were positively correlated with AHI and microarousal index （ r = 0. 500, P 〈 0. 05 ; r = 0. 561, P 〈 0.05 ）, and FT4 was also positively correlated with microarousal index （ r = 0. 542, P 〈 0.05 ）. （3）In OSAHS group, FT3 level was positively correlated with neck circumference（ t = 0. 489, P 〈 0.05 ）, TSH level was negatively correlated with neck circumference （ t = - 0.500, P 〈 0.05 ） and was positively correlated with the percentage of body fat （ r = 0.498, P 〈 0.05 ）. Condusioas The FT3 levels are significantly higher in the OSAHS patients than that in control subjects,though all FT3 levels are normal, suggesting that there are possibility to have abnormal metabolism. At the same time, FT3 level is positively correlated with neck circumference,suggesting that the OSAHS patients＇ higher neck circumference is correlated with thyroxine.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 游离三碘甲状腺原氨酸 游离甲状腺素 促甲状腺素 

分 类 号：R766[医药卫生—耳鼻咽喉科]