阻塞性睡眠呼吸暂停低通气综合征患者血浆VIP和β-EP水平的变化及意义  

Levels of VIP and β-EP in the plasma of patients with obstructive sleep apnea hypopnea syndrome and their significance

作　　者：詹俊杰[1] 李竹[1] 李江华[1] 牟基伟[1] 周旭峰[1] 张美佳[1] 杨琳红[1] 夏军[2] 魏晓丽[1] 

机构地区：[1]佳木斯大学附属第一医院,黑龙江佳木斯154003 [2]山东省菏泽市中医院,山东菏泽274000

出　　处：《黑龙江医药科学》2013年第6期3-6,共4页Heilongjiang Medicine and Pharmacy

基　　金：黑龙江省卫生厅科研项目;编号:2011-387

摘　　要：目的:通过检测血管活性肠肽(VIP)和β-内啡肽(β-EP)在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆中的含量,探讨二者在OSAHS发病过程中的病理生理意义,进而探讨二者可能的相互作用的机制。为OSAHS的病因诊断和治疗提供新的理论依据。方法:实验对象为45例经过多导睡眠监测(PSG)筛选的OSAHS患者,以呼吸暂停低通气指数(AHI)为标准进行分度,其中轻中度组29例,重度组16例。对照组为经PSG监测排除OSAHS诊断的健康成人志愿者15例。采用酶联免疫吸附法(ELISA)分别检测OSAHS组和正常对照组的血浆中VIP和β-EP的浓度。对VIP与β-EP的表达结果及二者的相关性进行统计学分析。结果:OSAHS患者血浆中VIP为高表达,表达差异具有显著性(P<0.01)。OSAHS轻中度组的VIP浓度显著高于对照组(P<0.01);重度OSAHS组的VIP浓度明显高于轻中度OSAHS组(P<0.01)。OSAHS患者血浆中β-EP为高表达,表达差异具有显著性(P<0.01)。OSAHS轻中度组的β-EP浓度显著高于对照组(P<0.01);重度OSAHS组的β-EP浓度明显高于轻中度OSAHS组(P<0.01)。在OSAHS重度组VIP与β-EP的表达呈正相关,且差异有统计学意义(P<0.01)。结论:VIP和β-EP在OSAHS患者血浆中均存在高表达,且重度组明显高于轻中度组,说明二者在OSAHS的疾病发生发展的过程中发挥了重要作用。VIP作为具有舒张血管作用的神经肽类物质,可以改善组织缺氧,但其过度表达可导致血管通透性增加,局部组织水肿,加重OSAHS的病情。β-EP的高表达,可构成缺氧、β-EP升高、呼吸抑制、缺氧这一恶性循环,导致OSAHS的病情的复杂化。VIP和β-EP两种神经肽在参与OSAHS疾病发生发展过程中呈现显著的正相关性。Objective：To detect the expression of vasoactive intestinal peptide（VIP） and β-endorphin（ β-EP） in the plasma of patients with obstructive sleep apnea hypopnea syndrome（OSAHS）; and to explore possible mechanisms of interaction; and to provide a new theoretical basis for the etiological diagnosis and treatment of OSAHS.Methods：The experimental subjects were 45 cases of patients with OSAHS diagnosed by polysomnography（PSG） monitoring.The patients were divided into mild and moderate group of 29 cases and severe group of 16 cases according to apnea hypopnea index（AHI） as the standard for indexing.The control group were 15 healthy adult volunteers who were excluded out of OSAHS by PSG monitoring.The enzyme-linked immunosorbent assay（ELISA） was used to detect the plasma VIP and β-EP concentration of patients in OSAHS group and normal control group.The results of expression of VIP and β-EP and their correlation were analyzed statistically.Results：IN OSAHS group,VIP showed high expression,and the expression differences were significant（P〈0.01）.In mild and moderate OSAHS group,VIP concentration was significantly higher（P〈0.01）; The VIP concentration in severe OSAHS group was significantly higher than that in mild and moderate OSAHS group（P〈0.01）. β-EP in plasma of patients with OSAHS showed high expression,expression differences were significant（P〈0.01）.In mild to moderate OSAHS group, β-EP concentration was significantly higher（P〈0.01）; in severe OSAHS group, β-EP concentrations were significantly higher than that in mild and moderate OSAHS group（P〈0.01）.In OSAHS severe group,VIP and β-EP expression was positively correlated with a correlation coefficient of 0.914,and the difference was statistically significant（P〈0.01）.Conclusion：VIP and β-EP in the plasma of patients with OSAHS were highly expressed,and the expression in severe group was significantly higher than that in mild and moderate group,indicating that VIP and β-EP may play an i

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 血管活性肠肽 Β-内啡肽 酶联免疫吸附法 

分 类 号：R563.9[医药卫生—呼吸系统]