血清SUMO特异性蛋白酶1/低氧诱导因子-1α通路对阻塞性睡眠呼吸暂停低通气综合征患者心血管事件结局的预测价值  

Predictive value of SENP⁃1/HIF⁃1αpathway on cardiovascular events in patients with obstructive sleep apnea hypopnea syndrome

作　　者：贾远航 谭小武 陈林涂 容芳 周芳 JIA Yuanhang;TAN Xiaowu;CHEN Lin;TU Rongfang;ZHOU Fang(Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital,Hengyang Medical School,University of South China,Hengyang 421001,China)

机构地区：[1]南华大学衡阳医学院附属第二医院呼吸与危重症医学科,湖南衡阳421001

出　　处：《实用医学杂志》2023年第6期719-723,729,共6页The Journal of Practical Medicine

基　　金：湖南省卫生健康委科研课题(编号:202203024555)。

摘　　要：目的探讨血清SUMO特异性蛋白酶1(SENP-1)/低氧诱导因子-1α(HIF-1α)通路对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者发生心血管事件(CVE)结局的预测价值。方法选取2018年1月至2021年3月于医院确诊为OSAHS的男性患者80例,根据睡眠呼吸暂停低通气指数(AHI)将其分为轻度组(43例)、中度组(22例)和重度组(15例),另选择同期在本院体检中心进行体检的43例正常健康男性为正常组。另外,根据随访1年期间内是否发生心血管事件(CVE)将80例OSAHS患者分为CVE组(28例)和非CVE组(52例)。比较患者临床基线资料、常规生化指标;采用ELISA法检测患者血清中SENP-1/HIF-1α通路相关蛋白SENP-1、HIF-1α及VEGF水平;采用多因素logistic回归分析OSAHS患者发生CVE的危险因素;采用受试者工作特征(ROC)曲线分析血清SENP-1、HIF-1α、VEGF水平对OSAHS患者发生CVE的预测价值。结果与轻度组比较,中度组和重度组患者体质指数、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、三酰甘油、血肌酐、AHI及Ts90%值均显著升高(P<0.05),LSpO2值显著降低(P<0.05),其中重度组最为显著(P<0.05)。与轻度组比较,中度组和重度组患者血清中SENP-1、HIF-1α、VEGF水平明显升高(P<0.05),其中重度组最为显著;与非CVE组比较,CVE组患者血清中SENP-1、HIF-1α、VEGF水平明显升高(P<0.05)。多因素logistic回归分析显示,血清SENP-1、HIF-1α、VEGF水平是OSAHS患者发生CVE的独立危险因素(OR=1.133、1.090、1.066,均P<0.05)。ROC曲线分析显示,血清SENP-1、HIF-1α、VEGF水平对OSAHS患者发生CVE均有预测价值,ROC曲线下面积分别为0.890、0.837、0.802(P<0.05)。结论血清中SENP-1、HIF-1α、VEGF水平升高是OSAHS患者发生CVE的独立危险因素,对OSAHS患者发生CVE具有预测价值。Objective To investigate the predictive value of SUMO specific protease 1(SENP⁃1)/hypoxia inducible factor⁃1(HIF⁃1α)pathway on the outcome of cardiovascular events(CVE)in patients with obstructive sleep apnea⁃hypopnea syndrome(OSAHS).Methods Eighty male patients diagnosed as OSAHS in our hospital from January 2018 to March 2021 were selected and divided into mild group(43 patients),moderate group(22 patients)and severe group(15 patients).At the same time,43 normal healthy men who had physical examination in the physical examination center of our hospital were selected as the normal group.In addition,80 OSAHS patients were divided into CVE group(28 cases)and non CVE group(52 cases)according to whether cardiovascular events(CVE)occurred during the 1⁃year follow⁃up period.Clinical baseline data and routine biochemical indexes of patients were collected;serum SENP⁃1,HIF⁃1αand VEGF of SENP⁃1/HIF⁃1αsignaling pathway were detected by ELISA assay;multivariate logistic regression was used to analyze the risk factors of CVE in OSAHS patients;ROC analysis of serum SENP⁃1,HIF⁃1αand VEGF level to predict on the occurrence of CVE in OSAHS patients.Results Compared with those in the mild group,the body mass index,alanine aminotransferase,glutamic oxalo⁃acetic transaminase,triglyceride,serum creatinine,AHI and Ts90%value in the moderate group and severe group were significantly increased(P<0.05),and LSpO2 value was significantly decreased(P<0.05),especially significantly in the severe group(P<0.05).Compared with that in the mild group,serum SENP⁃1,HIF⁃1αand VEGF level in the moderate group and severe group were significantly higher(P<0.05),especially higher in the severe group(P<0.05);serum SENP⁃1,HIF⁃1αand VEGF level in CVE group was significantly higher than that in non CVE group(P<0.05).Multivariate logistic regression analysis showed that serum SENP⁃1,HIF⁃1αand VEGF level were independent risk factors for CVE in OSAHS patients(OR=1.133,1.090,and 1.066 respectively,all P<0.05).ROC

关 键 词：血清SUMO特异性蛋白酶1 阻塞性睡眠呼吸暂停低通气综合征 心血管事件 危险因素 诊断价值 

分 类 号：R446.1[医药卫生—诊断学]