血清同型半胱氨酸水平、幽门螺杆菌感染在重症阻塞性睡眠呼吸暂停综合征中的作用  

Significance of serum homocysteine levels and Helicobacter pylori infection in patients with severe obstructive sleep apnea syndrome

作　　者：赵云青 Yun-Qing Zhao(Department of Respiratory Medicine,Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310000,Zhejiang Province,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院呼吸治疗科,浙江省杭州市310000

出　　处：《世界华人消化杂志》2018年第31期1843-1848,共6页World Chinese Journal of Digestology

摘　　要：目的分析血清同型半胱氨酸(Homocysteine, Hcy)水平、幽门螺杆菌(Helicobacter pylori, H. pylori)感染在阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome, OSAS)中的作用及H. pylori根除对OSAS患者的价值.方法选取2016-02/2018-02间在本院接受治疗并经多导睡眠监测仪(SOMNO screen PSG)确诊是OSAS患者90例,依据患者夜间血氧饱和度(oxygen saturation, SaO2)及睡眠呼吸暂停低通气指数(apnea hypopnea index,AHI)将其分成轻度(30例)、中度(34例)和重度(26例),选取同期在本院体检健康者80例作为对照组,对两组对象行PSG监测、检测血清生化指标,对OSAS患者行H. pylori感染检测,对H. pylori感染阳性者行抗感染治疗.结果 OSAS组轻度、中度及重度患者血清Hcy、D-二聚体含量、AHI及氧减饱和指数(oxygen desaturation index,ODI)对比对照组上升,CRP含量、L-SaO2、M-SaO2比对照组下降,且轻度、中度及重度呈现为逐渐上升或者下降趋势,差异均有统计学意义(P <0.05);血清Hcy下降组患者M-SaO 2、L-SaO 2比上升组升高, AHI、ODI比上升组降低,差异均有统计学意义(P <0.05); H.pylori感染阴性者Hcy含量、ODI及AHI比阳性者下降, M-SaO2、L-SaO2比阳性者升高,差异均有统计学意义(P<0.05).结论临床检测OSAS患者H.pylori感染状况及血清Hcy水平可在一定程度上反映患者病情发展情况,对H.pylori感染阳性者及时行H.pylori根除治疗可缓解其病情发展.AIM To analyze the significance of serum homocysteine(Hcy)levels and Helicobacter pylori(H.pylori)infection in patients with obstructive sleep apnea syndrome(OSAS)and assess the value of H.pylori eradication in these patients.METHODS A total of 90 patients who were diagnosed with OSAS using an SOMNO screen PSG and underwent treatment at our hospital from February 2016 to February 2018 were selected according to oxygen saturation(SaO2).Based on the apnea hypopnea index(AHI),the patients were divided into three groups:mild(30 cases),moderate(34 cases),and severe(26 cases).Eighty-eight healthy subjects were selected as a control group.PSG monitoring and measurement of serum biochemical indicators were performed in both groups,H.pylori infection was detected in OSAS patients,and anti-infective treatment was performed in H.pylori-positive patients.RESULTS Serum Hcy,D-dimer content,AHI,and oxygen desaturation index(ODI)were significantly higher,and C-reactive protein content,L-SaO2,and M-SaO2 were significantly lower in the OSAS group than in the control group(P<0.05);these indicators also showed a significant difference among the mild,moderate,and severe groups(P<0.05).In patients with decreased serum Hcy,M-SaO2 and L-SaO2 significantly increased,and AHI and ODI ratio significantly decreased compared with those with increased serum Hcy(P<0.05).Hcy content,ODI,and AHI were significantly lower,and M-SaO2 and L-SaO2 were significantly higher in H.pylori-negative patients than in H.pylori-positive patients(P<0.05).CONCLUSION H.pylori infection status and serum Hcy level in patients with OSAS can reflect the development of patients’condition to some extent.Timely eradication of H.pylori in OSAS patients can alleviate the disease.

关 键 词：阻塞性睡眠呼吸暂停综合征 幽门螺杆菌感染 血清同型半胱氨酸 

分 类 号：R766[医药卫生—耳鼻咽喉科] R573[医药卫生—临床医学]