低密度脂蛋白胆固醇升高对老年阻塞性睡眠呼吸暂停患者内皮微粒水平的影响  

The effect of elevated LDL cholesterol on endothelial microvesicle levels in elderly patients with obstructive sleep apnea

作　　者：吕颍妹 谭进[2] 邢慧芳 张蔷 Lyu Yingmei;Tan Jin;Xing Huifang;Zhang Qiang(Tianjin Geriatrics Institute,Tianjin 300052,China;Department of Geriatrics,Tianjin Medical University General Hospital,Tianjin 300052,China)

机构地区：[1]天津市老年病学研究所,300052 [2]天津医科大学总医院老年病科,300052

出　　处：《中华老年医学杂志》2020年第8期901-904,共4页Chinese Journal of Geriatrics

基　　金：国家自然科学基金(81970085,81670086)。

摘　　要：目的观察低密度脂蛋白胆固醇(LDL-C)水平升高对老年阻塞性睡眠呼吸暂停(OSA)患者循环血中内皮微粒释放的影响。方法病例对照研究,选取年龄≥60岁的老年住院患者69例,按照呼吸暂停低通气指数(AHI)分为OSA组48例和对照组21例,对两组患者进行睡眠监测,监测结束后进行静脉取血;密度梯度离心提取微粒,流式细胞仪分析患者血中内皮微粒的水平;生化全项检测患者血脂水平,并分析OSA患者LDL-C水平与内皮微粒的相关性。结果 OSA患者LDL-C水平为(2.6±0.6)mmol/L,高于正常对照组(2.2±0.7)mmol/L,差异具有统计学意义(t=2.089,P=0.041)。对照组老年人的内皮微粒水平为(19.6±7.8)×10-6个/L,老年OSA患者的内皮微粒水平为(28.2±12.2)×10-6个/L,老年OSA患者循环血中内皮微粒水平较对照组老年人明显增多(t=-3.164,P=0.003);OSA合并LDL-C水平升高患者内皮微粒水平为(39.3±12.6)×10-6个/L,较单纯OSA患者内皮微粒水平(28.2±12.2)×10-6个/L显著增多,差异有统计学意义(t=2.899,P=0.006)。OSA患者LDL-C水平与内皮微粒水平的相关性有统计学意义(r=0.497,P=0.032),而高密度脂蛋白胆固醇、血清总胆固醇、三酰甘油、血压、血糖等与内皮微粒水平的相关性无统计学意义。结论老年OSA患者循环血中内皮微粒的释放水平较正常人增高,LDL-C浓度升高能够进一步促进OSA患者内皮微粒的释放。Objective To investigate the effect of elevated low-density lipoprotein(LDL)cholesterol on the release of endothelial microvesicles into the circulatory system in elderly patients with obstructive sleep apnea(OSA)Methods This was a case-control study.A total of 69 elderly inpatients aged≥60 years were divided into the OSA group(n=48)and the normal control group(n=21)based on the apnea/hypopnea indexCAHI).Sleep monitoring was carried out in the two groups,and venous blood samples were taken after the monitoring.Density gradient centrifugation was used to extract microparticles and flow cytometry was used to analyze patients'blood levels of endothelial microvesicles.Blood lipid levels of patients were measured by biochemical analysis methods.The correlation between LDL cholesterol levels and endothelial microvesicles in OSA patients was analyzed.Results LDL cholesterol levels were higher in OSA patients than in normal controls(2.6±0.6 mmol/L n 2.2±0.7 mmol/L,t=2.089,P=0.041).Endothelial microvesicle levels were elevated in OSA patients compared with the normal controls[(28.2±12.2)×10^-6 events/L-ys.(19.6±7.8)×10^-6 events/Lt=—3.164,P=0.003].Endothelial microvesicle levels increased in OSA patients with elevated LDL cholesterol compared with OSA patients with normal LDL cholesterol[(39.3±12.6)×10^-6 events/L(28.2±12.2)×10^-6 events/L,t=2.899,P=0.006].There was a significant correlation between LDL cholesterol levels and endothelial microvesicle levels in OSA patients(r=0.497,P=0.032),while levels of HDL,total cholesterol,triglycerides,blood pressure and blood glucose had no significant correlation with endothelial microvesicle levels.Conclusions The level of endothelial microvesicles released into the circulation is higher in elderly OSA patients than in normal elderly people>and the elevated concentration of LDL can further promote the release of endothelial microvesicles in OSA patients.

关 键 词：睡眠呼吸暂停 阻塞性 脂蛋白类 LDL 内皮细胞 

分 类 号：R766[医药卫生—耳鼻咽喉科]