血清低氧诱导因子-1α和同型半胱氨酸与C反应蛋白对阻塞性睡眠呼吸暂停低通气综合征合并高血压的预测价值  

Predictive value of serum hypoxia inducible factor-1α,homocysteine and C-reactive protein in patients with obstructive sleep apnea hypopnea syndrome complicated with hypertension

作　　者：夏菁 蔡思洁 张秀琴[2] XIA Jing;CAI Sijie;ZHANG Xiuqin(Department of Pulmonary and Critical Care Medicine,The First People's Hospital of Kunshan,Suzhou,Jiangsu,215300,China;Department of Pulmonary and Critical Care Medicine,First Affiliated Hospital of Suzhou University,Suzhou,Jiangsu,215006,China)

机构地区：[1]昆山市第一人民医院呼吸与危重症医学科,江苏苏州215300 [2]苏州大学附属第一医院呼吸与危重症医学科,江苏苏州215006

出　　处：《当代医学》2024年第34期7-13,共7页Contemporary Medicine

基　　金：昆山市慈善总会广仁基金科研课题(临床研究专项)一般项目(Y22-118-100966)。

摘　　要：目的分析血清低氧诱导因子-1α(hypoxia inducible factor-1α,HIF-1α)、同型半胱氨酸(homocysteine,Hcy)、C反应蛋白(C-reactive protein,CRP)在阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)合并高血压患者中的表达及其对OSAHS合并高血压的预测价值。方法选取2017年1月至2019年12月于昆山市第一人民医院睡眠监测中心就诊且行多导睡眠图(polysomnography,PSG)监测的247例患者作为研究对象,根据PSG监测结果分为OSAHS组(n=196)与非OSAHS组(n=51),再根据是否合并高血压分为OSAHS合并高血压组(A组,n=94)、单纯OSAHS组(B组,n=102)、鼾症合并高血压组(C组,n=28)、单纯鼾症组(D组,n=23)。所有患者均行PSG监测及血清HIF-1α、Hcy、CRP水平检测,比较4组临床资料、主要睡眠呼吸参数[呼吸暂停低通气指数(apnea-hypopnea index,AHI)、平均经皮动脉血氧饱和度(mean percutaneous arterial oxygen saturation,MSpO_(2))、最低经皮动脉血氧饱和度(low percutaneous arterial oxygen saturation,LSpO_(2))、经皮动脉血氧饱和度<90%的累积时间占总睡眠时间百分比(percutaneous arterial oxygen saturation<90%of total sleep time percentage,TRTSpO_(2)<90%)]及血清HIF-1α、Hcy、CRP水平,分析A组患者血清HIF-1α、Hcy、CRP及其与主要睡眠参数的相关性,绘制受试者工作特征(receiver operating characteristic curve,ROC)曲线分析血清HIF-1α、Hcy、CRP对OSHAS合并高血压及单纯OSHAS的预测价值。结果A组、B组年龄、体重指数、颈围均大于C组、D组,差异有统计学意义(P<0.05),A组男性比例均高于C组、D组,差异有统计学意义(P<0.008),其他组间各指标两两比较差异均无统计学意义。A组AHI、TRTSpO_(2)<90%均高于B组、C组、D组,MSpO_(2)、LSpO_(2)均低于B组、C组、D组,且B组AHI、TRTSpO_(2)<90%均高于C组、D组,MSpO_(2)、LSpO_(2)均低于C组、D组,差异有统计学意义(P<0.05);C组与D组AHI、MSpO_(2)、LSpO_(2)、TRTSpO_(2)<90%�Objective To analyze the levels of serum hypoxia inducible factor-1α(HIF-1α),homocysteine(Hcy),C-reactive protein(CRP)in ob‐structive sleep apnea hypopnea syndrome(OSAHS)complicated with hypertension and their predictive values in the diagnosis of hypertension com‐plicated with OSAHS.Methods 247 patients who treated and underwent polysomnography(PSG)monitoring in department of Sleep Monitoring Center of The First People's Hospital of Kunshan from January 2017 to December 2019 were selected as the research subjects,and they were divided into the OSAHS group(n=196)and the non-OSAHS group(n=51)according to the PSG monitoring results,and they were further divided into the OSAHS complicated with hypertension(group A,n=94),OSAHS alone group(group B,n=102),snoring complicated with hypertension(group C,n=28)and snoring alone group(group D,n=23).All the patients underwent PSG monitoring and serum HIF-1α,Hcy and CRP levels were detected,the clinical data,major sleep respiratory parameters(apnea-hypopnea index[AHI],mean percutaneous arterial oxygen saturation[MSpO_(2)],low percuta‐neous arterial oxygen saturation[LSpO_(2)],percutaneous arterial oxygen saturation<90%of total sleep time percentage[TRTSpO_(2)<90%])and HIF-1α,Hcy and CRP levels were compared among the four groups,the correlations among serum HIF-1α,Hcy,CRP and their correlations with major sleep parameters were analyzed in the group A.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum HIF-1α,Hcy and CRP for OSHAS with hypertension and OSHAS alone.Results The age,body mass index and neck circumference in the group A and group B were higher than those in the group C and group D,and the differences were statistically significant(P<0.05),the proportion of males in the group A was higher than that in the group C and group D,and the differences were statistically significant(P<0.008),there was no statistically sig‐nificant difference in each index between the other groups in pairwise comparisons.AHI,TRTSpO_(2)<

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 高血压 低氧诱导因子-1Α 同型半胱氨酸 C反应蛋白 

分 类 号：R54[医药卫生—心血管疾病]