男性阻塞性睡眠呼吸暂停低通气综合征患者血清性激素水平观察  

Serum sex hormone levels among male patients with obstructive sleep apnea hypopnea syndrome

作　　者：刘翔[1] 崔壮[2] 杨相立[1] LIU Xiang;CUI Zhuang;YANG Xiangli(Dept of Otolaryngology-Head&Neck Surgery,Tianjin People’s Hospital,Tianjin,300121,China)

机构地区：[1]天津市人民医院耳鼻咽喉头颈外科,300121 [2]天津医科大学流行病与公共卫生学院

出　　处：《中国中西医结合耳鼻咽喉科杂志》2024年第4期241-244,共4页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：天津市卫生局科技基金面上项目(2011KY17)。

摘　　要：目的观察分析男性阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者血清性激素水平的临床病理意义。方法选取OSAHS患者102例为实验组,慢性扁桃体炎患者80例为对照组,化学发光免疫分析法分别检测两组患者的雌二醇、睾丸酮、孕酮水平,分析血清性激素水平与患者年龄、打鼾病史、呼吸暂停病史、呼吸暂停低通气指数(apnea hypopnea index,AHI)、体质量指数(body mass index,BMI)、颈围、腹围、血压、吸烟、饮酒、疾病程度、腭咽部狭窄程度、Epworth嗜睡量表评分、合并的全身系统疾病等指标之间的相关性。结果实验组血清睾丸酮水平低于对照组,两组雌二醇、孕酮水平差异无统计学意义。OSAHS患者睾丸酮、孕酮水平与患者AHI、BMI、Epworth睡眠量表评分、颈围、腹围呈负相关,雌二醇水平及雌二醇/睾丸酮(e/t)比值与患者AHI、BMI、Epworth睡眠量表评分、颈围、腹围呈正相关(P<0.05)。e/t比值随年龄的增长逐渐增大。结论男性OSAHS患者的雌激素水平随病情加重而增加,其发病可能与睾丸酮水平降低或睾丸酮与雌二醇比例失衡有关。这种失衡也可能是老年男性OSAHS患病率增加的原因。Objective To investigate the clinicopathological implications of serum sex hormone levels among male patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods Included in this trial were 102 male patients with OSAHS taken as the experimental group(EG),with another 80 patients with chronic tonsillitis as control(CG).Determined among these cases were their such serum levels of sex hormones as estradiol,testosterone and progestin by chemiluminescence immunoassay to evaluate their possible associations with such parameters of these patients as age,history of snoring and apnea,apnea hypopnea index(AHI),body mass index(BMI),neck circumference,abdominal circumference,blood pressure,smoking,drinking,severity of illness and palatopharyngeal stenosis,Epworth Sleeping Scale(ESS),and systemic comorbidities in a comparative way between the two groups.Results The serum testosterone level of EG were obviously lower than that of CG,while that of estrogen and progestin were determined with no significantly statistical differences between the two groups.Among the cases with OSAHS,the levels of testosterone and progestin were negatively correlated with such indicators as AHI,BMI,Epworth sleeping scale,neck circumference and abdominal circumference,while the levels of estrogen and the ratio of estrogen/testosterone(e/t)were positively correlated with AHI,BMI,Epworth sleeping scale,neck circumference and abdominal circumference(P<0.05).Furthermore,e/t ratio was gradually increased with age among them.Conclusion Estrogen level among male cases usually increase with the exacerbation of OSAHS,with its pathogenesis possibly associated with reduction of testosterone level or imbalance between testosterone and estrogen.Such an imbalance in the ratio of testosterone to estrogen may be the possible reason for the increased prevalence of OSA in the elder men.

关 键 词：OSAHS 男性 性激素水平 临床病理意义 

分 类 号：R766[医药卫生—耳鼻咽喉科]