阻塞性睡眠呼吸暂停低通气综合征患者血清鸢尾素、成纤维细胞因子21、视黄醇结合蛋白4水平变化及临床意义  

Changes and Clinical Significance of Serum Irisin,Fibroblast Growth Factor 21 and Retinol-Binding Protein 4 Levels in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

作　　者：许冰 王莹 韩书芝[2] XU Bing;WANG Ying;HAN Shuzhi(Graduate School,Hebei North University,Zhangjiakou 075000,China;Department of Geriatric Respiratory Medicine,Hebei General Hospital,Shijiazhuang 050000,China;Graduate School,Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北北方学院研究生院,河北省张家口市075000 [2]河北省人民医院老年呼吸内科,河北省石家庄市050000 [3]河北医科大学研究生院,河北省石家庄市050000

出　　处：《实用心脑肺血管病杂志》2025年第6期75-81,共7页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：2021年省直医疗机构老年病防治经费项目(2021380)。

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清鸢尾素(irisin)、成纤维细胞因子21(FGF21)、视黄醇结合蛋白4(RBP4)水平变化及临床意义。方法选取2023年10月—2024年6月河北省人民医院收治的OSAHS患者80例为病例组,同时选取同时期河北省人民医院收治的非OSAHS患者55例为对照组。收集受试者的一般资料、血清学指标,根据多导睡眠监测结果将病例组患者进一步分为轻度OSAHS亚组(n=13)、中度OSAHS亚组(n=14)、重度OSAHS亚组(n=53)。采用Spearman秩相关分析探讨OSAHS患者血清irisin、FGF21、RBP4水平与呼吸暂停低通气指数(AHI)及三者间的相关性,采用有序Logistic回归分析探讨OSAHS病情严重程度的影响因素。结果病例组年龄大于对照组,有饮酒史者占比、有高血压史者占比、TC、TG、LDL-C及血清FGF21、RBP4水平高于对照组,HDL-C、血清irisin水平低于对照组(P<0.05)。中度OSAHS亚组血清irisin水平低于轻度OSAHS亚组,血清FGF21、RBP4水平高于轻度OSAHS亚组;重度OSAHS亚组年龄大于轻度OSAHS亚组,BMI高于轻度OSAHS亚组,TC高于中度OSAHS亚组,血清irisin水平低于轻度OSAHS亚组、中度OSAHS亚组,血清FGF21、RBP4水平高于轻度OSAHS亚组、中度OSAHS亚组(P<0.05)。Spearman秩相关分析结果显示,OSAHS患者血清irisin水平与AHI呈负相关(rs=-0.396,P<0.001);血清FGF21水平与AHI呈正相关(rs=0.559,P<0.001);血清RBP4水平与AHI呈正相关(rs=0.469,P<0.001);血清irisin水平与血清FGF21水平呈负相关(rs=-0.339,P=0.002);血清irisin水平与RBP4无直线相关关系(rs=-0.220,P=0.05);血清FGF21水平与血清RBP4水平呈正相关(rs=0.363,P<0.001)。有序Logistic回归分析结果显示,BMI、血清irisin、FGF21、RBP4水平是OSAHS病情严重程度的独立影响因素(P<0.05)。结论OSAHS患者血清irisin水平降低,血清FGF21、RBP4水平升高,三者均与OSAHS病情严重程度相关,且其是OSAHS病情严重程度的独立影响因素。Objective To investigate the changes and clinical significance of serum irisin,fibroblast growth factor 21(FGF21),and retinol-binding protein 4(RBP4)levels in patients with obstructive sleep apnoea hypopnoea syndrome(OSAHS).Methods A total of 80 OSAHS patients admitted to Hebei General Hospital from October 2023 to June 2024 were selected as the case group,and 55 non-OSAHS patients admitted to Hebei General Hospital during the same period were selected as the control group.Clinical data and serological indicators of subjects were collected,the patients in case group were further divided into mild OSAHS subgroup(n=13),moderate OSAHS subgroup(n=14),and severe OSAHS subgroup(n=53)based on the results of polysomnography monitoring.Spearman rank correlation analysis was used to explore the correlation between serum irisin,FGF21,RBP4 levels and apnea hypopnea index(AHI),as well as the relationship between serum irisin,FGF21 and RBP4 levels in patients with OSAHS.Ordinal Logistic regression analysis was used to explore the influencing factors for severity of OSAHS.Results The age in case group was older than that in control group,proportion of people with drinking history,proportion of people with hypertension history,TC,TG,LDL-C,and serum FGF21 and RBP4 levels were higher than those in control group,HDL-C,serum irisin level were lower than those in control group(P<0.05).The serum irisin level in moderate OSAHS subgroup was lower than that in mild OSAHS subgroup,the serum FGF21 and RBP4 levels were higher than those in mild OSAHS subgroup;the age in severe OSAHS subgroup was older than that in mild OSAHS subgroup,BMI was higher than that in mild OSAHS subgroup,TC was higher than that in moderate OSAHS subgroup,serum irisin level was lower than that in mild OSAHS subgroup and moderate OSAHS subgroup,and serum FGF21 and RBP4 levels were higher than those in mild OSAHS subgroup and moderate OSAHS subgroup(P<0.05).Spearman rank correlation analysis showed that in OSAHS patients,serum irisin level was negatively correlated w

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 鸢尾素 成纤维细胞因子21 视黄醇结合蛋白4 脂肪因子 

分 类 号：R563.4[医药卫生—呼吸系统]