阻塞性睡眠呼吸暂停低通气综合征患者血浆miR-191与白细胞介素-6表达水平及临床意义  

Expressions and clinical significances of miR-191and interlukin-6 in patients with obstructive sleep apnea hypopnea syndrome

作　　者：孙泽蕊 何响 解友邦[2] 顾玉海[1] 多杰[1] 石雪峰[1] SUN Zerui;HE Xiang;XIE You-bang;GU Yu-hai;DUO Jie;SHI Xue-feng(Department of Respiration and Critical Care Medicine,Qinghai Provincial People's Hospital,Xining,Qinghai 810007,China;Department of Haematological Rheumatology,Qinghai Provincial Peopled Hospital,Xiningt Qinghai 810007,China)

机构地区：[1]青海省人民医院呼吸与危重症医学科,青海西宁810007 [2]青海省人民医院血液风湿科,青海西宁810007

出　　处：《中华实用诊断与治疗杂志》2022年第2期173-177,共5页Journal of Chinese Practical Diagnosis and Therapy

基　　金：青海省卫生计生系统重点课题(2017-wjzd-10);青海省人民医院院内指导课题(2018-004)

摘　　要：目的观察阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome, OSAHS)患者血浆白细胞介素(interleukin, IL)IL-6水平及血浆miR-191、IL-6受体(IL-6 receptor, IL-6R)表达情况,探讨其与睡眠呼吸暂停指数(apnea-hypopnea index, AHI)的关系及预测OSAHS患者合并糖尿病的价值。方法 OSAHS患者60例为观察组,同期体检健康者30例为对照组,采用实时荧光定量PCR法检测2组血浆miR-191、IL-6R mRNA相对表达量;采用ELISA法检测2组血浆IL-6水平;采用Pearson相关性分析OSAHS患者血浆miR-191和IL-6R mRNA相对表达量、血浆IL-6水平、最低氧饱和度、平均氧饱和度与AHI的相关性。60例OSAHS患者根据是否合并糖尿病分为合并糖尿病组39例和未合并糖尿病组21例,比较2组平均氧饱和度、最低氧饱和度、血浆miR-191和IL-6R mRNA相对表达量及血浆IL-6水平等临床资料;采用多因素logistic回归分析OSAHS患者合并糖尿病的影响因素;绘制ROC曲线,评估血浆miR-191相对表达量、IL-6水平及最低氧饱和度预测OSAHS患者合并糖尿病的效能。结果观察组血浆miR-191(34.95±16.09)、IL-6R mRNA(20.63±10.56)相对表达量及血浆IL-6水平[(55.24±15.20)ng/L]均高于对照组[9.10±8.21、13.85±8.86、(28.82±10.11)ng/L](t=10.093,P<0.001;t=3.021,P=0.003;t=9.809,P<0.001);OSAHS患者血浆miR-191、IL-6R mRNA相对表达量及血浆IL-6水平与AHI均呈正相关(r=0.354,P=0.006;r=0.288,P=0.026;r=0.309,P=0.016),最低氧饱和度、平均氧饱和度与AHI均呈负相关(r=-0.302,P=0.019;r=-0.298,P=0.021)。合并糖尿病组AHI[(52.37±21.03)次/h]、血浆miR-191相对表达量(40.27±15.67)、血浆IL-6水平[(60.15±14.22)ng/L]均高于未合并糖尿病组[(36.91±15.57)次/h、25.07±11.80、(44.23±12.89)ng/L](t=2.955,P=0.005;t=3.884,P<0.001;t=4.273,P<0.001),最低氧饱和度[(53.51±11.05)%]、平均氧饱和度[(73.31±9.61)%]均低于未合并糖尿病组[(69.10±5.43)%、(82.19±6.97)%](t=7.315,P<0.001;t=4.106,P<0.001Objective To observe the relative expressions of plasma interleukin(IL)-6, miR-191 and IL-6 receptor(IL-6 R) in patients with obstructive sleep apnea hypopnea syndrome(OSAHS), and to investigate their correlations with apnea-hypopnea index(AHI) and their values to the prediction of diabetes in OSAHS patients. Methods The relative expressions of plasma miR-191 and IL-6 R mRNA were detected by real-time fluorescence quantitative PCR in 60 OSAHS patients(observation group) and 30 healthy volunteers(control group). The plasma IL-6 level was detected by ELISA in two groups. Pearson correlation method was used to analyze the correlations of the relative expressions of plasma miR-191 and IL-6 R mRNA, the plasma IL-6 level, the lowest oxygen saturation(LSaO;) and the mean oxygen saturation(MSaO;) with AHI in OSAHS patients. Sixty OSAHS patients were divided into diabetes group(n=39) and non-diabetes group(n=21). and the MSaO;, the LSaO;, the relative expressions of miR-191 and IL-6 R mRNA, and the plasma IL-6 level were compared between two groups. Multivariate logistic regression analysis was done to evaluate the influencing factors of diabetes in patients with OSAHS. ROC curve was drawn to assess the efficiencies of the relative expression of miR-191, the plasma IL-6 level and the LSaO;on predicting diabetes in OSAHS patients. Results The relative expressions of plasma miR-191 and IL-6 R mRNA as well as the plasma level of IL-6 were higher in observation group [34.95±16.09, 20.63±10.56,(55.24±15.20) ng/L] than those in control group [9.10±8.21, 13.85±8.86,(28.82±10.11) ng/L](t=10.093, P<0.001;t=3.021, P=0.003;t=9.809, P<0.001). The relative expressions of miR-191 and IL-6 R mRNA as well as the IL-6 level were positively correlated with AHI in OSAHS patients(r=0.354, P=0.006;r=0.288, P=0.026;r=0.309, P=0.016), while LSaO;and MSaO;were negatively correlated with AHI(r=-0.302, P=0.019;r=-0.298, P=0.021). The AHI, the relative expression of plasma miR-191 and the IL-6 level were higher in diabetes group [(52.37±21.0

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 糖尿病 miR-191 白细胞介素-6受体 白细胞介素-6 

分 类 号：R766[医药卫生—耳鼻咽喉科]