成人OSAHS患者短程无创正压通气治疗前后血清髓过氧化物酶、胰淀素的水平测定及意义  

Determination and significance of serum MPO and amylin in adult patients with OSAHS after short-range noninvasive positive pressure ventilation

作　　者：陈晓鸿[1] 陈丕绩 隆琰[1] 黄秋平[1] 

机构地区：[1]中山大学附属第八医院(深圳福田)耳鼻咽喉头颈外科,广东深圳518033 [2]深圳市第七人民医院检验科

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第11期873-876,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨成人OSAHS患者短程无创正压通气(CPAP)治疗前后血清髓过氧化物酶(MPO)、胰淀素的水平测定及意义。方法:87例OSAHS患者根据AHI分为重度组(30例)、中度组(30例)、轻度组(27例);以门诊健康者27例为对照组。采用ELISA法测定受试者血清MPO和胰淀素。30例重度OSAHS患者行CPAP治疗3个月和6个月复测MPO、胰淀素,分析MPO、胰淀素与PSG指标的关系。结果:(1)随着OSAHS病情程度增加,血MPO、胰淀素水平均逐渐上升(F=22.486,19.755;P<0.01);其中轻度组与对照组MPO、胰淀素浓度差异无统计学意义(P>0.05),余各间相互比较均有明显差别(P<0.01)。(2)OSAHS患者血清MPO、胰淀素水平和BMI、年龄没有关联(P>0.05),与LSaO_2呈负相关,和AHI呈正相关(P<0.01);血MPO与胰淀素水平呈正相关(r=0.466,P<0.01)。(3)30例重度患者经CPAP治疗3个月LSaO_2较前上升,AHI及外周血MPO、胰淀素水平较前降低(P<0.01);治疗6个月MPO、胰淀素水平较治疗3个月降低(P<0.05),但与对照组比较仍有升高(P<0.05)。结论:联合测定成人OSAHS患者血清胰淀素、MPO浓度对病情、疗效的判断及并发糖尿病及胰岛素抵抗危险性预测有一定参考价值。CPAP治疗可明显降低OSAHS患者缺氧程度和胰岛功能损害,其疗效和疗程相关。Objective：The aim of this study to investigate the determination and significance of serum MPO and amylin in adult patients with OSAHS after short-range noninvasive positive pressure ventilation. Method： Eighty-seven OSAHS patients were divided into severe group（30 cases）, moderate group （30 cases） and mild group （27 cases） according to the AHI range. Twenty-seven outpatient health persons were selected as the control group. Serum amylin and myeloperoxidase were measured by ELISA; Amyloid and myeloperoxidase were reas- sessed in 30 patients with severe OSAHS after 6 months of combined therapy, and the relationship between amy- lin, myeloperoxidase and PSG was analyzed. Result： ①With the severity of OSAHS patients increased, the serum amylin and myeloperoxidase levels gradually increased（F= 22. 486,19. 755;P〈0.01）; There was no significant difference in MPO and amylin concentration between the mild group and the control group（P〈0.05）, and the oth- er groups were significantly different from each other（P〈0.01）. ②There was no correlation among serum amylin and myeloperoxidase level and BMI and age in OSAHS patients（P〈0.05） ; and a negative correlation with SaO2, and AHI was positively correlated（P〈0.01）. ③After 3 months of CPAP treatment, LSaOz increased which the AHI and peripheral blood MPO, amylin levels lower than before in 30 patients（P〈0.05） ; The amylin and my- eloperoxidase concentrations of blood after 6 months of treatment were significantly lower than those of 3 months after treatment（P〈0.05）, which still increased compared with the control group. Conclusion：The determination of serum amylin and MPO in patients with OSAHS has a certain reference value in predicting the condition and cura- tive effect of diabetes mellitus and insulin resistance. CPAP treatment can significantly reduce the degree of hy- poxiapatients and cardiovascular damage in OSAHS patients, which was significantly correlated with the treatment time.

关 键 词：睡眠呼吸暂停低通气综合征 阻塞性 髓过氧化物酶 胰淀素 胰岛素抵抗 

分 类 号：R563.8[医药卫生—呼吸系统]