阻塞型睡眠呼吸暂停低通气综合征患者血清对氧磷酶1活性与血脂的变化及相关性探讨  

The changes of serum paraoxonase-1 activity and blood lipid in patients with obstructive sleep apnea-hypopnea syndrome and their correlation study

作　　者：曹梅[1] 陈飞鹏[1] 邬勇坚[1] 陈晓军[1] 

机构地区：[1]广州医学院第二附属医院呼吸内科,510260

出　　处：《中国医师进修杂志》2012年第22期39-42,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的研究阻塞型睡眠呼吸暂停低通气综合征（OSAHS）患者血清对氧磷酶1（PON1）活性和血脂的关系，及经鼻持续气道正压通气（nCPAP）治疗前后的变化，探讨PONl在OSAHS并发心血管疾病中的可能作用。方法86例OSAHS患者根据睡眠呼吸暂停指数（AHI）分为3组：轻度组（5〈AHI±20）24例，中度组（20〈AHI±40）25例，重度组（AHI〉40）37例。检测各组间血脂水平及PON1活性并与20例健康者（对照组）进行比较，相关参数进行相关性分析，其中21例中、重度OSAHS患者进行nCPAP治疗3个月后复查多导睡眠图（PSG）、PON1活性和血脂。结果轻度组、中度组、重度组血清PON1活性分别为（143．56±29．47）、（121．50±25．76）、（103．11±24．54）ku几，均低于对照组的（164．35±33．89）kU/L，差异有统计学意义（P〈0．05或〈0．01）。不同程度的OSAHS患者血清PON1活性比较差异有统计学意义（P〈0．05或〈0．01），且血清PONl活性随OSAHS程度加重而下降。血清PON1活性与HDL水平呈正相关（r=0．658，P〈0．01），与AHI呈负相关（r=-0．637，P〈0．01）。21例中、重度OSAHS患者经3个月nCPAP治疗后血清PON1活性为（110．88±11．03）ku几，较治疗前的（102．25±10．02）ku／L明显升高，差异有统计学意义（P〈0．01）。结论PON1可能参与OSAHS并发心血管疾病的发生，nCPAP治疗可能有助于降低OSAHS患者并发心血管疾病的危险性。Objective To study the correlation between serum paraoxonase-1 （PON-1） activity and blood lipid and their changes before and after nasal continuous positive airway pressure ventilation （nCPAP） in patients with obstructive sleep apnea-hypopnea syndrome （OSAHS） and to investigate the effect of PON-1 on the occurrence of cardiovascular diseases in OSAHS patients. Methods According to the apnea hypopnea index（AHI ）, 86 OSAHS patients were divided into mild group（24 cases, 5 〈 AHI 〈 20）, moderate group （25 cases,20 〈 AHI ≤40） and severe group （37 eases,AHI 〉 40）. Blood lipid levels and PON-1 activity were measured in all the subjects and compared with those in 20 healthy persons （control group）, and the correlations with related indexes were analyzed. Results The serum PON-1 activity in mild group,moderate group and severe group were signifiCantly lower than that in control group [ （143.56 ± 29.47）, （121.50 ±25.76）, （103.11 ±24.54） kU/L vs.（164.35±33.89） kU/L] （P 〈0.05 or 〈0.01）. There was statistical significance in serum PON-1 activity among the three OSAHS groups （P〈 0.05 or 〈 0.01 ）. Serum PON-1 activity decreased with the severity of OSAHS. The serum PON-1 activity was positively correlated to HDL level （r = 0.658, P 〈 0.01 ） and negatively correlated to AHI （r = -0.637, P 〈 0.01 ）. After 3-month nCPAP therapy ,PON-1 activity in 21 patients with moderate and severe OSAHS was significantly higher than that before therapy [ （ 110.88 ± 11.03） kU/L vs. （ 102.25 ± 10.02 ） kU/L, P 〈 0.01 ]. Conclusions PON - 1 may contribute to the occurrence of cardiovascular diseases in OSAHS patients, nCPAP therapy may help to reduce the occurrence risk of cardiovascular diseases in OSAHS patients.

关 键 词：睡眠呼吸暂停 阻塞性 芳基二烷基磷酸酶 心血管疾病 血脂异常 连续气 道正压通气 

分 类 号：R766[医药卫生—耳鼻咽喉科]