阻塞性睡眠呼吸暂停低通气综合征患者血清γ-谷氨酰基转移酶与颈动脉粥样硬化的相关性  

Correlations between serumγ-glutamyltransferase and carotid atherosclerosis in patients with obstructive sleep apnea hypopnea syndrome

作　　者：褚叶 程丽 金晶[1] 刘剑勇 CHU Ye;CHENG Li;JIN Jing;LIU Jianyong(Zhangjiagang Hospital,Nanjing University of Chinese Medicine,Zhangjiagang 215600,China;不详)

机构地区：[1]南京中医药大学张家港附属医院,江苏张家港215600 [2]苏州大学附属张家港医院,江苏张家港215600

出　　处：《实用医学杂志》2021年第20期2651-2655,共5页The Journal of Practical Medicine

基　　金：张家港市科技支撑计划(社会发展)项目(编号:ZKS1726)。

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清γ-谷氨酰基转移酶(γ-GT)与颈动脉粥样硬化的相关性。方法收集2016年3月至2019年7月在我院行多导睡眠监测(PSG)的患者153例,基于睡眠呼吸暂停低通气指数(AHI)分为对照组(n=51)、轻-中度OSAHS组(n=58)、重度OSAHS组(n=44);依据颈动脉内膜中层厚度(CIMT)分为颈动脉硬化组和非颈动脉硬化组。比较各组间一般临床资料、PSG监测指标和生化指标的差异,行CIMT与相关指标的相关性分析,并进一步行多因素logistic回归分析。结果重度OSAHS组、轻-中度OSAHS组、对照组在体质量指数(BMI)、高血压比例、收缩压(SBP)、舒张压(DBP)、AHI、减氧指数(ODI)、氧饱和度低于90%的时间占睡眠期的百分比(Ts90%)、夜间最低指脉氧饱和度(L-SaO_(2))、甘油三酯(TG)、空腹血糖(FPG)、γ-GT、CIMT比较,差异有统计学意义(P<0.05)。重度OSAHS组、轻-中度OSAHS组、对照组γ-GT水平分别是(41.45±7.14)、(34.50±6.62)、(25.26±5.31)U/L(P<0.001)。与非颈动脉硬化组比较,颈动脉硬化组SBP、AHI、ODI、Ts90%、TG、低密度脂蛋白胆固醇(LDL-C)、FPG、γ-GT水平较高,L-SaO_(2)较低,差异有统计学意义(P<0.05)。颈动脉硬化组、非颈动脉硬化组γ-GT水平分别是(36.27±6.21)、(28.45±6.39)U/L(P<0.001)。Pearson相关性分析显示CIMT与年龄、SBP、AHI、ODI、Ts90%、TG、FPG、γ-GT呈正相关(P<0.05),与L-SaO_(2)呈负相关(P<0.05)。Spearman秩相关显示CIMT与高血压呈正相关(P<0.05)。多元logistic回归显示血清γ-GT水平增高是OSAHS患者颈动脉粥样硬化的独立危险因素(OR=2.124,P<0.001)。结论血清γ-GT水平随着OSAHS患者病情严重程度逐渐增高,且与CIMT呈正相关,是OSAHS患者发生颈动脉粥样硬化的独立危险因素,在临床工作中具有重要意义。Objective To investigate the correlations between serumγ-glutamyl transferase(γ-GT)and carotid atherosclerosis in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 153 patients who received polysomnography(PSG)from March 2016 to July 2019 were enrolled and divided into control group(n=51),mild to moderate OSAHS group(n=58),and severe OSAHS group(n=44)based on sleep apnea hypopnea index(AHI).According to carotid intima-media thickness(CIMT),they were divided into carotid sclerosis group and non-carotid sclerosis group.The differences in the general clinical data,PSG monitoring indexes and biochemical indexes were compared between the groups.The correlation analysis between CIMT and the related indexes was performed,and multivariate Logistic regression analysis was further performed.Results There were significant differences between the three groups in terms of the body mass index(BMI),proportion of hypertension,systolic blood pressure(SBP),diastolic blood pressure(DBP),AHI,oxygen deoxygenation index(ODI),the time when oxygen saturation was below 90%in the sleeping period(TS90%),the lowest nocturnal finger oxygen saturation(L-SaO_(2)),triglyceride(TG),fasting blood glucose(FPG),γ-GT and CIMT(P<0.05).The serumγ-GT levels in the severe OSAHS group,the mild-moderate OSAHS group and the control group were(41.45±7.14),(34.50±6.62)and(25.26±5.31)U/L,respectively(P<0.001).Compared with the non-carotid atherosclerosis group,SBP,AHI,ODI,TS90%,TG,LDL-C,FPG,γ-GT levels were all significantly higher in the carotid atherosclerosis group,and L-SaO_(2) levels were significantly lower in the carotid atherosclerosis group(P<0.05).The serumγ-GT levels in the carotid and non-carotid atherosclerosis groups were(36.27±6.21)and(28.45±6.39)U/L,respectively(P<0.001).Pearson correlation analysis showed that CIMT was positively correlated with age,SBP,AHI,ODI,TS90%,TG,FPG,γ-GT(P<0.05),and CIMT was negatively correlated with L-SaO_(2)(P<0.05).Spearman rank correlation showed that CIMT was positivel

关 键 词：Γ-谷氨酰基转移酶 颈动脉粥样硬化 阻塞性睡眠呼吸暂停低通气综合征 颈动脉内膜中层厚度 相关性 

分 类 号：R562[医药卫生—呼吸系统]