老年冠心病合并阻塞性睡眠呼吸暂停综合征患者ghrelin/obestatin比值的变化及意义  

Change and significance of ghrelin / obestatin in elderly patients with coronary heart disease complicated with obstructive sleep apnea hypopnea syndrome

作　　者：严爱芬[1] 吴伟萍[1] 陈捷[1] 陈玉婷[1] 

机构地区：[1]余姚市人民医院检验科,浙江余姚315400

出　　处：《中华全科医学》2017年第2期302-303,307,共3页Chinese Journal of General Practice

基　　金：2011年浙江省医药卫生科技计划项目(2011KYA-147)

摘　　要：目的探讨老年冠心病合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者胃饥饿素(ghrelin)/肥胖抑制素(obestatin)比值变化及临床意义。方法收集2014年1月—2015年12月在余姚市人民医院确诊的冠心病患者112例作为研究对象,根据是否合并OSAHS分为冠心病合并OSAHS组(48例)和单纯冠心病组(64例),选择同期健康志愿者40例作为对照组。采用ELISA法测定血清ghrelin、obestatin水平。根据冠脉造影结果采用Gensini积分评估冠脉病变程度,使用多导睡眠图(PSG)监测确诊OSAHS。结果冠心病合并OSAHS组、单纯冠心病组患者的ghrelin/obestatin比值显著低于对照组,差异均有统计学意义(P<0.05或P<0.01)。冠心病合并OSAHS组患者的Gensini积分明显高于单纯冠心病组,差异有统计学意义(P<0.05)。冠心病合并OSAHS组患者的ghrelin/obestatin比值与Gensini积分、AHI呈负相关。结论老年冠心病合并OSAHS患者的ghrelin/obestatin比值与冠状动脉病变程度密切相关。ghrelin/obestatin比值有可能作为预测老年冠心病合并OSAHS的预测指标之一。Objective To investigate the change and clinical significance of ghrelin / obestatin in elderly patients with coronary heart disease complicated with obstructive sleep apnea hypopnea syndrome（ OSAHS）. Methods We collected 112 cases of coronary heart disease patients in the people＇s hospital of Yuyao as research subjects and divided them into coronary heart disease complicated with OSAHS group（ n = 48） and simple coronary heart disease group（ n = 64） according to the complication of OSAHS from January,2014 to December,2015. 40 cases of healthy people were selected as a control group at the same period. ELISA was used to determine serum Ghrelin and obestatin levels. Gensini score was used to evaluate the extent of coronary lesions according to the results of coronary angiography,and polysomnography（ PSG） monitoring was used to the diagnosis of OSAHS. Results The ghrelin / obestatin ratio of coronary heart disease complicated with OSAHS group and simple coronary heart disease group were significantly lower than that of the control group,the difference were statistically significant（ P 〈0. 05 or P〈 0. 01）. The Gensini score of coronary heart disease complicated with OSAHS group were significantly higher than that in the simple coronary heart disease group,the difference were statistically significant（ P 〈0. 05）. The ghrelin / obestatin ratio of patients with coronary heart disease complicated with OSAHS was negatively correlated with Gensini score and AHI（ r =- 0. 72,- 0. 55,P 〈0. 05）. Conclusion Ghrelin /obestatin ratio is closely related to the degree of coronary artery disease in patients with coronary heart disease complicated with OSAHS. Ghrelin / obestatin ratio could one of indicator for prediction of coronary heart disease complicated with OSAHS.

关 键 词：冠心病 阻塞性睡眠呼吸暂停低通气综合征 ghrelin/obestatin比值 冠状动脉病变程度 

分 类 号：R541.4[医药卫生—心血管疾病] R446.61[医药卫生—内科学]