非肥胖阻塞性睡眠呼吸暂停低通气综合征患者血清高敏C反应蛋白水平变化及意义  

Relationship between obstructive sleep apnea-hypopnea syndrome and high sensitivity C-reactive protein in non-obese subjects

作　　者：林其昌[1] 谢汉生[1] 刘雪君[1] 周金玲[1] 赵建铭[1] 

机构地区：[1]福建医科大学附属第一医院呼吸内科,福建医科大学呼吸系病研究室,福州350005

出　　处：《中华医学杂志》2013年第30期2355-2358,共4页National Medical Journal of China

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）非肥胖患者血清高敏c反应蛋白（hs—CRP）水平变化情况。方法收集从2011年7月至2012年6月来福建医科大学附属第一医院睡眠疾病诊治中心行睡眠呼吸监测的非肥胖患者体质量指数（BMI）〈25kg／m2，根据呼吸暂停低通气指数（AHI）将其分为非OSAHS组及轻、中、重度OSAHS组，比较各组性别、年龄、BMI、嗜睡量表（ESS）评分、平均血氧饱和度、呼吸暂停低通气指数（AHI）、最低血氧饱和度及hs—CRP水平。结果共收集了65例患者，男53例，女12例，平均年龄（44．3±12．2）岁，其中非OSAHS组17例，OSAHS组48例。两组间性别、年龄、BMI、ESS评分、平均血氧饱和度的差异均无统计学意义（均P〉0．05），AHI、最低血氧饱和度的差异均有统计学意义（均P〈0．01），两组间血清hs．CRP水平的差异有统计学意义（P=0．03）。与非OSAHS组相比较，轻、中度OSAHS组hs—CRP水平差异无统计学意义，重度OSAHS组hs—CRP水平升高差异有统计学意义（P=0．004）。血清hs—CRP与各因素的Pearson相关分析显示，hs—CRP水平与AHI呈正相关关系，r为0．407（P=0．001）；与年龄、BMI、ESS评分、最低血氧饱和度、平均血氧饱和度的相关性差异无统计学意义（P〉0．05）。以hs—CRP为因变量做多元逐步回归分析显示，只有AHI是hs—CRP水平升高的可靠预测因子（R2=0．166，P=0．001）。结论非肥胖OSAHS患者的血清hs—CRP水平升高，hs—CRP水平升高与OSAHS的严重程度相关。Objective To evaluate the relationship between high sensitivity C-reactive protein （hs- CRP） level and the severity of obstructive sleep apnea-hypopnea syndrome （OSAHS） in non-obese patients. Methods A total of 65 patients with suspected OSAHS were recruited. Those with a history of cardiovascular or cerebrovascular events, arterial hypertension, chronic obstructive pulmonary disease, diabetes mellitus and smoking were excluded. All subjects were examined by polysomnography. Subjects with an apnea-hypopnea index （AHI） ≥ 5 were considered to have OSAHS. They were divided into mild, moderate and severe OSAHS groups and those with an AHI 〈 5 were accepted into the control group. The serum level of hs-CRP, a biomarker for cardiovascular disease, was measured with peripheral venous blood samples. Results There were 53 males and 12 females with a mean age 44. 3 ± 12. 2 years and a body mass index （BMI） 〈 25 kg/m2. The serum levels of hs-CRP were significantly higher in OSAHS patients than those of the controls （ geometric mean [ 95% confidence interval I 0. 416 [ 0. 288 - 0. 600 ] vs 0. 749 [ 0. 559 - 1. 003 ] rag/L, P 〈 0. 05 ）. Mean levels of hs-CRP did not differ between the group with mild-to- moderate OSAHS and the control group. However, the severe OSAHS group had a higher level of hs-CRP than the control group （ P = 0. 004）. A significant positive relationship existed between hs-CRP and AHI （ r = 0. 407, P = 0. 001 ）. According to stepwise multivariate analysis, only AHI was a reliable predictor for elevated serum level of hs-CRP among all these related factors （R2 = 0. 166, P = 0. 001 ）. Conclusion The severity of OSAHS is associated with an elevated serum level of hs-CRP in non-obese patients.

关 键 词：睡眠呼吸暂停 阻塞性 C反应蛋白质 肥胖 心血管疾病 

分 类 号：R740[医药卫生—神经病学与精神病学] R563.9[医药卫生—临床医学]