IMA和DJ-1在阻塞性睡眠呼吸暂停低通气综合征临床监测中的意义  

Significance of IMA and DJ-1 in clinical management of obstructive sleep apnea-hypopnea syndrome

作　　者：张永红[1] 陈栋 张德信[1] 刘昀[1] 史红阳[1] 谢梅[1] 霍彩芳 孙秀珍[1] ZHANG Yonghong;CHEN Dong;ZHANG Dexin;LIU Yun;SHI Hongyang;XIE Mei;HUO Caifang;SUN Xiuzhen(Department of Respiratory and Critical Care Medicine,Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China;Medical Laboratory,Second Affiliated Hospital of Xi’an Jiaotong University)

机构地区：[1]西安交通大学第二附属医院呼吸与危重症医学科,西安710004 [2]西安交通大学第二附属医院医学检验科

出　　处：《山西医科大学学报》2021年第12期1610-1614,共5页Journal of Shanxi Medical University

基　　金：西安交通大学第二附属医院院基金自由探索项目(2020YJ(ZYTS)144)。

摘　　要：目的探讨IMA、DJ-1与阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome, OSAHS)的关系。方法选取自愿参与本研究的113例可疑OSAHS患者,每位研究对象均进行至少7 h多导睡眠监测,按照呼吸暂停低通气指数(apnea hypopnea index, AHI)将其分为对照组(AHI<5,n=26)、轻度OSAHS组(5≤AHI≤15,n=21)、中度OSAHS组(15<AHI≤30,n=28)和重度OSAHS组(AHI>30,n=38)。检测四组研究对象的血浆DJ-1蛋白(PARK7基因编码的家族蛋白)和血清缺血修饰白蛋白(ischemia modified albumin, IMA)水平,分析OSAHS患者血浆DJ-1、血清IMA水平与年龄、体质量指数、吸烟指数、最低血氧饱和度、睡眠紊乱指数的相关关系。观察重度OSAHS患者经鼻持续气道正压通气(nasal-continuous positive airway pressure, NCPAP)治疗前后血浆DJ-1和血清IMA的变化。结果与对照组比较,轻度、中度和重度OSAHS组患者IMA水平均明显升高(P<0.05);在OSAHS患者中,重度OSAHS组患者IMA水平最高,其次是中度OSAHS组,轻度OSAHS组最低(P<0.05)。与对照组比较,中度OSAHS组和重度OSAHS组DJ-1水平均明显升高(P<0.05);重度OSAHS组DJ-1水平较中度OSAHS组明显升高(P<0.05),而DJ-1水平在轻度OSAHS组与中度OSAHS组,轻度OSAHS组与对照组间差异无统计学意义。OSAHS患者血浆DJ-1和血清IMA水平与睡眠监测参数显著相关(P<0.05)。重度OSAHS患者经鼻持续正压通气(nasal-continuous positive airway pressure, NCPAP)治疗3个月,患者的血浆DJ-1和血清IMA水平显著下降,治疗前后差异具有统计学意义(P<0.05)。结论血浆DJ-1和血清IMA可能是评估OSAHS严重程度的潜在生物学标志,有助于OSAHS的临床监管。Objective To investigate the relationship between the level of plasma DJ-1(a family protein encoded by PARK7 gene),serum ischemia modified albumin(IMA) and obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods A total of 113 suspected OSAHS patients who volunteered to participate in this study were selected. After polysomnography monitor for at least 7 h, the patients were divided into four groups according to apnea hypopnea index(AHI): control group(AHI<5, n=26), mild OSAHS group(5≤AHI≤15, n=21), moderate OSAHS group(15<AHI≤30, n=28) and severe OSAHS group(AHI>30, n=38). Plasma DJ-1 and serum IMA levels were detected in each group. The correlations between DJ-1,IMA levels and age, body mass index, smoking index, minimum blood oxygen saturation, sleep disorder index were analyzed, and the changes of DJ-1 and IMA levels in patients with severe OSAHS after nasal-continuous positive airway pressure(NCPAP) treatment were observed. Results Compared with control group, serum IMA level was significantly increased in mild, moderate and severe OSAHS groups(P<0.05), and the level was gradually increased in mild, moderate and severe OSAHS groups(P<0.05). Compared with control group, the plasma level of DJ-1 was significantly increased in moderate OSAHS group and severe OSAHS group(P<0.05), the plasma level of DJ-1 in severe OSAHS group was significantly higher than that in moderate OSAHS group(P<0.05), while there was no statistically significant difference between mild OSAHS group and moderate OSAHS group or between mild OSAHS group and control group. DJ-1 and IMA levels were significantly correlated with sleep monitoring parameters in OSAHS patients, and the levels of DJ-1 and IMA in severe OSAHS were significantly decreased after NCPAP treatment for three months(P<0.05). Conclusion Plasma DJ-1 and serum IMA may be potential biomarkers for assessing the severity of OSAHS, and have important significance for clinical supervision of OSAHS.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 DJ-1 IMA 生物标志物 

分 类 号：R563[医药卫生—呼吸系统]