阻塞性睡眠呼吸暂停患者血浆脂联素、炎性因子与心功能早期损伤相关  

Correlation between serum adiponectin,inflammatory factors and early cardiac dysfunction in patients with obstructive sleep apnea

作　　者：李杰茹[1] 高秀华[2] 韩聚强[1] 康立英[1] 罗文彦[1] LI Jieru;GAO Xiuhua;HAN Juqiang;KANG Liying;LUO Wenyan(Hebei University of Chinese Medicine,Shijiazhuang,Hebei 050200,China)

机构地区：[1]河北中医学院,石家庄050200 [2]中国人民解放军白求恩国际和平医院,石家庄050082

出　　处：《实用医学杂志》2019年第9期1445-1449,共5页The Journal of Practical Medicine

基　　金：河北省科技厅资助(河北省重点研发计划项目)(编号:18277786D)

摘　　要：目的旨在探讨阻塞性睡眠呼吸暂停(OSA)患者血浆脂联素(APN)和炎性因子与心功能早期损伤的关系。方法依据睡眠呼吸暂停指数(AHI)将首诊的OSA患者分为轻、中、重三组,匹配正常对照组,各20例。检测受试者血浆中APN和炎性因子水平,描记超声心动参数。选取31例中、重度OSA患者,给予持续正压通气(CPAP)治疗,结束后检测上述指标。结果 (1)对比对照组,OSA患者AHI、E/Em、炎性因子明显增高,Em/Am和APN明显降低(均P <0.05),但LVEF无明显变化(P> 0.05)。(2)相关分析:AHI与E/Em、炎性因子分别正相关,与Em/Am负相关(均P <0.05);E/Em与血浆炎性因子呈正相关(均P <0.05);APN与血浆炎性因子、E/Em均呈负相关(均P <0.05)。(3)OSA患者CPAP治疗后,AHI、E/Em及血浆炎性因子均明显降低,血浆中APN升高(均P <0.05)。结论单纯OSA患者可出现心功能早期损伤,早期心功能损伤与炎症反应及血浆中APN降低有关;CPAP治疗可能基于改善OSA患者间歇性低氧、升高APN、降低血浆炎性因子进而使早期受损心功能得以改善。Objective To investigate the relationship between plasma adiponectin(APN),inflammatory factors and early cardiac dysfunction in patients with OSA. Methods All subjects recruited were evaluated by polysomnography during sleep and divided into four groups based on their apnea hypopnea index( AHI):control group( n = 20),m ild OSA group( n = 20),m oderate OSA group( n = 20)and severe OSA group( n = 20).The levels of serum APN,inflammatory factors were detected. Routine ultrasound and tissue doppler parameters were recorded. In addition,thirty one cases of moderate-severe OSA patients were administrated with continuous positive airway pressure( CPAP)therapy for four weeks. The related indicators of OSA patients were measured before and after treatment of CPAP. Results Compared with the control group,A HI and E/Em of OSA patients were significantly higher,and Em/Am of OSA patients was significantly lower( P < 0.05),but LVEF of OSA patients did not change significantly(P > 0.05). Level of inflammatory factors in OSA patients was significantly increased,however, the APN level was obviously decreased( all P < 0.05).( 2)C orrelation analysis showed that AHI was positively correlated with E/Em,and AHI was negatively correlated with Em/Am,and inflammatory factors were positively correlated with E/Em(all P < 0.05). However,APN was negatively correlated with inflammatory factors, E/Em( all P < 0.05).( 3)A HI,E/Em and plasma inflammatory factors in OSA patients after CPAP treatment were significantly reduced,and plasma APN in OSA patients was increased after CPAP treatment(all P < 0.05). Conclusion Early cardiac dysfunction could occur in patients with OSA,and it was related with inflammatory reaction and decreased APN. CPAP treatment increased the serum levels of APN,reduced AHI value,and decreased the levels of inflammatory factors in serum,and alleviated early cardiac function injury.

关 键 词：睡眠呼吸暂停 炎性因子 脂联素 LVEF E/Em 

分 类 号：R766[医药卫生—耳鼻咽喉科]