男性阻塞性睡眠呼吸暂停低通气综合征血浆同型半胱氨酸变化的研究  

The plasma level of homocysteine in male patients of obstructive sleep apnea and hypopnea syndrome.

作　　者：王玮[1] 孔德磊[1] 康健[1] 

机构地区：[1]中国医科大学附属一院呼吸疾病研究所,沈阳110001

出　　处：《中国实用内科杂志》2011年第3期198-200,共3页Chinese Journal of Practical Internal Medicine

基　　金：国家自然科学基金(30871136)

摘　　要：目的评估男性不同程度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与血浆同型半胱氨酸(Hcy)的关系。方法选取2008年10月至2010年12月中国医科大学附属第一医院男性OSAHS患者45例,分为轻中度组23例和重度组22例以及健康男性对照组20名,用酶联免疫吸附试验比较各组间血浆Hcy浓度。22例重度OSAHS患者在治疗1个月后再次行Hcy检测。结果OSAHS患者血浆Hcy浓度较对照组明显升高[(15.9±7.8)μmol/L对(10.0±1.2)μmol/L,P<0.01],与夜间SpO2<90%时间占总睡眠时间的百分比呈显著正相关(r=0.441,P<0.01),与夜间平均SpO2呈负相关(r=-0.393,P<0.01)。然而分组比较后,只有重度OSAHS患者Hcy浓度[(19.6±6.7)μmol/L]高于对照组(P<0.01),经治疗后虽有明显降低[(15.4±4.8)μmol/L],但仍高于对照组(P<0.01)。结论重度OSAHS可引起血浆Hcy浓度升高,与低氧程度密切相关,治疗后血浆Hcy浓度有所下降。Objective To investigate the correlation between various degrees of male patients of obstructive sleep apnea and hypopnea syndrome （OSAHS） and plasma level of homocysteine （Hey）. Methods 45 male OSAHS patients allocated to mild-to-moderate and severe groups were matched with 20 healthy male controls. Enzyme-linked immunosorhent assay （ELISA） was used to measure Hey in these groups. The 22 OSAHS patients in severe group were re-evaluated for plasma Hey at one month after treatment. Results Overall,the Hey concentration was significantly elevated in OSAHS patients as compared with the normal control group [ （15.9±7.8）μmol/L vs （ 10. 0±1.2） μmol/L,P 〈0. 01 ] ,and was positively correlated with the percentage of sleep time below 90% oxygen saturation（ SpO2 〈 90% ） in the total sleep time （ r = 0. 441 ,P 〈 0. 01 ） hut negatively correlated with the mean SpO2 （ MSpO2 ） （ r = - 0. 393, P 〈 0. 01 ）. After allocation of groups, only the severe group showed higher Hey level[ （19. 6±6. 7 ）μmol/L] than that in the normal control group （P 〈 0. 01 ） , which was remarkably lowered after treatment [ （11. 4 ±4. 8 ）μmol/L] but remained higher than that in the normal control group （ P 〈 0. 01 ）. Conclusion The elevated Hey level in severe OSAHS may he closely correlated with various degrees of hypoxemia, which may become lowered after treatment.

关 键 词：阻塞性睡眠呼吸暂停 同型半胱氨酸 内皮功能 

分 类 号：R5[医药卫生—内科学]