持续气道正压通气治疗对阻塞性睡眠呼吸暂停综合征患者血清IL-6和hs-CRP水平影响  

Effect of Continuous Positive Airway Pressure Treatment on Serum Levels of IL-6 and hs-CRP in Patients With Obstructive Sleep Apnea Syndrome

作　　者：甄国粹[1] 罗志扬[1] 董微 李敏菁[1] 龙琴[1] 刘春霞[1] 

机构地区：[1]佛山市第一人民医院呼吸内科睡眠疾病诊疗中心,广东佛山528000 [2]肇庆市四会万隆医院,广东肇庆526200

出　　处：《医学信息（中旬刊）》2010年第9期2312-2313,共2页Medical Information Operations Sciences Fascicule

摘　　要：目的:通过研究阻塞性睡眠呼吸暂停综合征(OSAS)患者血清白细胞介素-6(IL-6)和超敏C反应蛋白(hs-CRP)的水平以及经持续气道正压通气(CPAP)治疗前后的水平变化,探讨IL-6和hs-CRP在OSAS患者发病机制及病理生理中的作用。方法:①新近诊断为OSAS患者62例及正常对照32例,所有观察对象于晨起采集静脉血标本,采用放射免疫分析法检测血清IL-6、散射比浊法检测血清hs-CRP水平。比较OSAS组与对照组间血清IL-6、hs-CRP水平的差异;②分析OSAS患者血清IL-6、hs-CRP水平与睡眠呼吸暂停低通气指数(AHI)和最低血氧饱和度的相关性;③OSAS组患者进行CPAP治疗3个月后复查上述各项指标,比较CPAP治疗前后血清IL-6、hs-CRP水平变化。结果:⑴OSAS组患者血清IL-6和hs-CRP水平分别为(128.38±36.62)pg/ml,(3.56±1.47)mg/l。较对照组升高(97.49±26.74)pg/ml,(2.17±1.06)mg/l,差异有统计学意义(P<0.01);⑵OSAS患者血清IL-6和hs-CRP水平与其AHI相关系数分别为0.599(P<0.01),0.497(P<0.01),呈正相关。OSAS患者血清IL-6和hs-CRP水平与其最低血氧饱和度相关系数分别为-0.583(P<0.05),-0.532(P<0.05),呈负相关;⑶OSAS患者进行CPAP治疗3个月后,回访53例,再次测定血清IL-6、hs-CRP水平,分别为(104.53±26.74)pg/ml,(2.65±1.22)mg/l,较治疗前减低,差异有统计学意义(P<0.01)。结论:OSAS患者血清IL-6、hs-CRP水平较正常升高,这可能是OSAS患者合并心脑血管疾病的原因之一,CPAP治疗能有效地降低OSAS患者的血清IL-6及hs-CRP水平。Objective：To explore the changes of serum interleukin-6（IL-6） and high-sensitivity C-reactive protein （hs-CRP） levels and the effect of continuous positive airway pressure（CPAP） therapy in patients with obstructive sleep apnea syndrome （OSAS）.Methods：Serum levels of IL-6 and hs-CRP were measured in 62 patients with newly diagnosed OSAS both before and after CPAP therapy as well as in 32 controls.Results：Before CPAP therapy,serum levels of IL-6 and hs-CRP in patients with OSAS were obviously increased than those in control subjects（128.38±36.62pg/ml） and （3.56±1.47mg/l） vs （97.49±26.74pg/ml） and （2.17±1.06mg/l）,（P0.01）.Those levels were significantly positively correlated with the apnea hypopnea index （AHI） （r=0.599,0.497,P0.01） but were significantly negatively correlated with the lowest SaO2 level （r=-0.583,-0.532,P0.05）.After treatment with CPAP for three months,serum levels of IL-6 and hs-CRP were obviously decreased （104.53±26.74pg/ml and 2.65±1.22mg/l,vs pre-treatment levels,P0.01）.Conclusion：Levels of IL-6 and hs-CRP are elevated in patients with OSAS,These maybe one of the reasones for OSAS complicated cardiovascular disease,CPAP therapy could effectively decrease serum levels of IL-6 and hs-CRP in patients with OSAS.

关 键 词：阻塞型睡眠呼吸暂停综合征 白细胞介素-6 超敏C反应蛋白持续气道正压通气 

分 类 号：R766.43[医药卫生—耳鼻咽喉科]