阻塞性睡眠呼吸暂停低通气综合征患者自动调节持续气道正压通气治疗前后氧化应激水平的变化  

Changes ofoxidative stress in patients with obstructive sleep apnea hypopnea syndrome before and after auto-continuous positive airway pressure ventilation

作　　者：都勇[1] 丁怡[1] 陈旭如 何炜[1] 施天昀 揭志军[1] Du Yong;Ding Yi;Chen Xuru;He Wei;Shi Tianyun;Jie Zhijun(Department of Pulmonary and Critical Care Medicine,the Fifth People's Hospital of Shanghai,Fudan University,Shanghai 200240,China)

机构地区：[1]复旦大学附属上海市第五人民医院呼吸与危重症医学科,上海200240

出　　处：《临床内科杂志》2019年第7期451-454,共4页Journal of Clinical Internal Medicine

基　　金：上海市第五人民医院重点专科资助项目(2017WYZDZK07).

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者自动调节持续气道正压通气(auto-CPAP)治疗前后氧化应激水平的变化。方法纳人中重度OSAHS患者50例,所有患者均行多导睡眠呼吸监测记录呼吸暂停低通气指数(AHI)和夜间最低血氧饱和度(LPO2),并予以auto-CPAP治疗3个月。分别于治疗前后检测所有患者血清8-异前列腺F2α(8-iso-PGF2α)、丙二醛(MDA)及过氧化氢酶(CAT)水平的变化并进行比较。采用Pearson相关分析评估OSAHS患者血清8-iso-PGF2α、MDA及CAT水平与AHI、LpO2的相关性。结果治疗前重度OSAHS患者血清8-iso-PGF2α和MDA水平均高于中度OSAHS患者,血清CAT水平低于中度OSAHS患者(P<0.05)。OSAHS患者血清8-iso-PGF2α、MDA水平与AHI均呈正相关(r=0.64,P<0.01;r=0.63,P<0.01),与LpO2均呈负相关(r=-0.47,P<0.01;r=-0.52,P<0.01);血清CAT水平与AHI呈负相关(r=-0.53<0.01),与LpO2呈正相关(r=0.51,P<0.01)。OSAHS患者治疗后血清8-iso-PGF2α和MDA水平低于治疗前,血清CAT水平髙于治疗前(P<0.01)。结论氧化应激与OSAHS的严重程度存在相关性,auto-CPAP治疗可明显改善OSAHS患者的氧化应激水平。Objective To explore the changes of oxidative stress in patients with obstructive sleep apnea hypopnea syndrome(OSAHS)before and after treatment of auto-continuous positive airway pressure ventilation(auto-CPAP).Methods Fifty patients with moderate and severe OSAHS were included.All patients were monitored by polysomnography to record apnea hypopnea index(AHI)and nocturnal lowest saturation of pulse oxygen(LpO2).All patients were treated with auto-CPAP for 3 months.Levels of serum 8-iso-prostaglandinF2a(8-iso-PGF2α),malondialdehyde(MDA)and catalase(CAT)were detected and compared before and after treatment.Pearson correlation analysis was used to evaluate the correlation among levels of serum 8-iso-PGF2α,MDA,CAT with AHI,LpO2 in patients with OSAHS.Results Levels of serum 8-iso-PGF2αand MDA in patients with severe OSAHS were higher than those in patients with moderate OSAHS before treatment,while level of serum CAT was lowere than that in patients with moderate OSAHS(P<0.05).Levels of serum 8-iso-PGF2αand MDA in patients with OSAHS were positively correlated with AHI(r=0.64,P<0.01 r=0.63,P<0.01),while were negatively correlated with LpO2(r=-0.47,P<0.01 r=-0.52,P<0.01).Levels of serum CAT in patients with OSAHS was negatively correlated with AHI(r=-0.53,P V 0.01),while were positively correlated with LpO2(r=0.51,P<0.01).Levels of serum 8-iso-PGF2αand MDA after treatment were significantly lower than those before treatment(P<0.01),while level of serum CAT was significantly higher than that before treatment(P<0.01).Conclusion Oxidative stress is associated with the severity of OSAHS,while auto丒CPAP can significantly improve the level of oxidative stress.

关 键 词：氧化应激 阻塞性睡眠呼吸暂停低通气综合征 自动调节持续气道正压通气 

分 类 号：R766[医药卫生—耳鼻咽喉科]