阻塞性睡眠呼吸暂停患者血清Chemerin水平与血管内皮功能的关系  

Correlation between serum chemerin level and vascular endothelium function in patients with obstructive sleep apnea hypopnea syndrome

作　　者：阳书坤[1] 张佳宾[2] 丘自挺[3] 徐福琴[3] 许梅妹[3] 

机构地区：[1]深圳市龙岗区人民医院呼吸内科,广东深圳518172 [2]兰州大学第一医院呼吸科,甘肃兰州730000 [3]深圳市龙岗区人民医院ICU,广东深圳518172

出　　处：《临床荟萃》2012年第13期1115-1117,1120,共4页Clinical Focus

摘　　要：目的探讨男性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清Chemerin水平与血管内皮功能的关系。方法选择OSAHS患者80例和健康对照组40例,分别使用酶联免疫吸附法测定所有受试者血清Chemerin因子、内皮素1(ET-1)、血管性血友病因子(vWF)水平,应用硝酸盐还原酶法测定一氧化氮(NO)水平,同时使用多普勒彩色超声测定肱动脉内径变化率。结果与对照组比较,OSAHS组血清Chemerin(0.51±0.09)ng/L vs(0.35±0.05)ng/L、ET-1(62.36±20.14)ng/Lvs(33.79±11.91)ng/L和vWF(30.35±12.67)μg/L vs(22.44±9.91)μg/L水平明显高于对照组(均P<0.01)。血清NO(36.33±11.89)μmol/L vs(41.19±14.56)μmol/L和肱动脉内径变化率(ΔD%8.95±4.15vs 14.08±3.79)明显低于对照组(均P<0.01)。Chemerin、ET-1和vWF水平与呼吸紊乱指数(AHI)呈正相关(r=0.641、0.552和0.469,均P<0.01),与最低血氧饱和度(LSaO2)均负相关(r=-0.551、-0.439和-0.528,均P<0.01)。Chemerin与ΔD%呈负相关(r=-0.496,P<0.01)。NO水平和ΔD%与AHI呈显著负相关(r=-0.536、-0.491,P<0.01),与LSaO2正相关(r=0.621、0.583,P<0.01)。ΔD%与AHI、MSaO2和血清Chemerin水平呈线性回归关系。结论 OSAHS患者存在着血清Chemerin升高和血管内皮功能损害,与患者严重程度和低氧密切相关;Chemerin是导致血管内皮功能损害的重要因素。Objective To analyze the correlation between plasma chemerin level and vascular endothelium function in male patients with obstructive sleep apnea hypopnea syndrome（OSAHS）. Methods 80 OSAHS patients （OSAHS group） and 40 healthy volunteers （control group） were recruited in the study. The states of vascular endothelium function were evaluated by ultrasonic imaging method and the levels of serum chemerin, nitric oxide（NO）, endothelin-1（ET-1） and yon Willebrand factor （vWF） were determined in both groups. Results Compared to the control group,the levels of serum chemerin （0.51±0.09） ng/L vs （0.35±0.05） ng/L,ET-1 （62. 36±20.14） ng/L vs （33.79±11.91） ng/L and vWF （30.35±12.67） μg/L vs （22.44±9.91） μg/L were significantly higher in patients with OSAHS（ P 〈0.01）. The levels of serum NO （36.33±11.89） μmol/L vs （41.19±14.56） μmol/L and brachial artery reactive hyperemia （8. 95±4.15 vs 14.08±3.79） were significantly decreased in patients with OSAHS（ P 〈 0.01）. The serum chemerin ET-1 and vWF levels were positive correlated to AHI （ r =0. 641,0. 552,0. 469） ,but they were negative correlated to the lowest SaO2 （r =-0. 551,-0. 439,-0. 528）. The level of serum NO and brachial artery reactive hyperemia were negative correlated to apnea hyponea index（AHl）（ r =-0. 536,-0. 491）, but they were positive related to the lowest SaO2 （ r =0. 621,0. 583 ,both P 〈0.01）. The brachial artery reactive hyperemia was in multiple linear regression with AHI,MSaO2 and serum chemerin level. Conclusion The level of serum chemerin was increased and the injury of vascular endothelium function existed in OSAHS patients, and they correlated to AHI and hypoxia during sleep.

关 键 词：睡眠呼吸暂停 阻塞性 内皮 血管 心电描记术 

分 类 号：R441.8[医药卫生—诊断学]