老年阻塞性睡眠呼吸暂停低通气综合征患者血脂异常与幽门螺杆菌感染的关系  

Correlation between dyslipidemia and Helicobacter pylori infection in elderly patients with obstructive sleep apnea hypopnea syndrome

作　　者：张辉[1] 吴允刚[1] 王彩华[1] 赵玉凤[1] 宋攀攀[1] 张永红[1] ZHANG Hui;WU Yun-gang;WANG Cai-hua;ZHAO Yu-feng;SONG Pan-pan;ZHANG Yong-hong(Department of Otolaryngology,Afiliated Hospital of Jining Medical University,Jining 272000,Shandong,China)

机构地区：[1]济宁医学院附属医院耳鼻喉科,山东济宁272000

出　　处：《广东医学》2022年第6期724-729,共6页Guangdong Medical Journal

基　　金：山东省卫生和计划生育委员会面上项目(2016WS0175);济宁市科技局一般项目(济科字[2016]56号-51)。

摘　　要：目的探讨老年阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者血脂异常与幽门螺杆菌(Helicobacter pylori,Hp)感染相关性。方法选择OSAHS老年患者120例为研究对象,根据疾病程度所有患者被分为轻度组(32例)、中度组(46例)和重度组(42例),另选取单纯鼾症患者30例作为对照组。收集患者基本临床资料,多导睡眠图(polysomnogram,PSG)监测血氧饱和度(oxygen saturation,SaO_(2))、呼吸暂停低通气指数(apnea hypopnea index,AHI);采集患者血清检测生化指标白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)、总胆固醇(total cholesterol,TC)、三酰甘油(triglycerides,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)及低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C);采用尿素^(13)C呼气实验检测有无Hp感染。结果随着OSAHS的发病及严重程度的增加,伴随高血压、高血脂、脑血管疾病、心脏病、Hp阳性发病比例及体质指数(body mass index,BMI)、IL-6、TNF-α、TC、LDL-C、TG、AHI均明显增加,最低SaO_(2)水平、HDL-C水平明显降低,差异有统计学意义(P<0.05);各组中,Hp阳性患者血清IL-6与TNF-α水平明显高于Hp阴性患者的水平,差异有统计学意义(P<0.05);Hp阳性患者的血脂异常患病率在不同程度OSAHS患者中均高于Hp阴性患者,在重度组差异最明显,差异有统计学意义(P<0.05);血脂异常危险因素分析显示,饮酒、AHI、Hp感染、IL-6及TNF-α是OSAHS患者发生血脂异常的独立危险因素。结论OSAHS患者血脂异常及Hp感染的比例随着疾病严重程度的增加而升高,且加重了心脑血管疾病的发生风险,OSAHS患者病情加重可能与Hp感染引起血脂异常有关。Objective To investigate the correlation between dyslipidemia and Helicobacter pylori(Hp)infection in elderly obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of 120 elderly patients with OSAHS were selected as subjects.According to the degree of disease,all patients were divided into 3 groups,including the mild group(32 cases),the moderate group(46 cases),and the severe group(42 cases).Another 30 patients with simple snoring were selected as the control group.Basic clinical data of all patients were collected.Blood oxygen saturation(SaO_(2))and apnea hypopnea index(AHI)were monitored by polysomnogram(PSG).Serum samples were collected for the detection of biochemical indicators,including interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C).The Hp screw was detected by Urea^(13)C breath test.Results With the occurrence and severity of OSAHS increasing,the proportion of hypertension,hyperlipidemia,cerebrovascular disease,heart disease,Hp positive and the levels of body mass index(BMI),IL-6,TNF-α,TC,LDL-C,TG,and AHI were significantly increased;while the minimum SaO_(2) and HDL-C were significantly reduced(P<0.05).In each group,the levels of IL-6 and TNF-αin patients with positive Hp were significantly higher than those in patients with negative Hp(P<0.05).In each group,the levels of serum IL-6 and TNF-αin patients with positive Hp were significantly higher than those in patients with negative Hp,and the difference was most significant in the severe group(P<0.05).Analysis of risk factors for dyslipidemia showed that drinking,AHI,Hp infection,IL-6 and TNF-αwere independent risk factors for dyslipidemia in OSAHS patients.Conclusion The incidence of dyslipidemia,Hp infection and cardiovascular and cerebrovascular diseases in OSAHS patients increases with the increase of disease severity,and the aggravation of OSAHS patients may be correlated to the dyslipidemia caused b

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 老年 血脂异常 幽门螺杆菌 

分 类 号：R856.76[医药卫生—航空、航天与航海医学] R767.1[医药卫生—临床医学]