您的位置：山东大学 -> 科技期刊社 -> 《山东大学学报（医学版）》

山东大学学报（医学版） ›› 2016, Vol. 54 ›› Issue (12): 67-71.doi: 10.6040/j.issn.1671-7554.0.2016.645

• 临床医学 • 上一篇    下一篇

成人阻塞性睡眠呼吸暂停低通气综合征外周血TM、MPO的检测及意义

张红霞1,徐永红2,陈莉2,龚辉成3   

  1. 1. 徐州医科大学护理学院, 江苏 徐州 221000;2. 徐州医科大学第二附属医院呼吸科, 江苏 徐州 221000;3. 广州市第十二人民医院耳鼻咽喉头颈外科, 广东 广州 510620
  • 收稿日期:2016-06-01 出版日期:2016-12-10 发布日期:2016-12-10
  • 通讯作者: 张红霞. E-mail: tracyhuge@sohu.com E-mail:tracyhuge@sohu.com

Detection of peripheral thrombomodulin and myeloperoxidase and their significance in adults with obstructive sleep apnea hypopnea syndrome

ZHANG Hongxia1, XU Yonghong2, CHEN Li2, GONG Huicheng3   

  1. 1. School of Nursing, Xuzhou Medical University, Xuzhou 221000, Jiangsu, China;
    2. Department of Respiratory, Second Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China;
    3. Department of ENT Head and Neck Surgery, Twelfth Peoples Hospital of Guangzhou, Guangzhou 510620, Guangdong, China
  • Received:2016-06-01 Online:2016-12-10 Published:2016-12-10

PDF (PC)

705

摘要： 目的 探讨成人阻塞性睡眠呼吸暂停低通气(OSAHS)患者血清血栓调节蛋白(TM)、髓过氧化物酶(MPO)的表达及意义。 方法 选取2014年3月至2016年2月耳鼻咽喉头颈外科收治的OSAHS患者90例(OSAHS组),根据睡眠呼吸暂停低通气指数(AHI)分为轻、中、重度OSAHS组,每组30例;门诊体检健康者30例为对照组。于多导睡眠监测仪检测次日清晨,空腹抽取患者外周血,采用酶联免疫吸附测定法(ELISA)测定各组血清TM、MPO水平。重度OSAHS组取持续正压通气(CPAP)及手术综合治疗,CPAP治疗6~8 d后评估患者狭窄气道平面,选择合适的手术方案治疗。重度OSAHS组在综合治疗后复测TM、MPO,分析TM、MPO以及检测的相关指标。 结果 血清TM和MPO水平与OSAHS患者严重程度呈正相关(P<0.05);轻度OSAHS组TM、MPO水平与对照组相比差异无统计学意义(P>0.05),中、重度OSAHS组与对照组相比差异有统计学意义(P<0.05);重度OSAHS组体质量指数较轻、中度OSAHS组和对照组明显提高(P<0.05);OSAHS患者血清TM、MPO水平和体质量指数、年龄、性别无相关性(P>0.05),而与血清浓度及AHI呈正相关性(P<0.05),与夜间最低血氧饱和度(LsaO2)呈负相关性(P<0.05)。重度OSAHS组在综合治疗后LsaO2显著上升,AHI及外周血TM、MPO水平明显降低(P<0.05)。 结论 外周血TM、MPO浓度的上升是OSAHS患者并发心血管损害的机制之一,检测血清TM、MPO浓度有助于判断患者的病情、疗效及评估并发心血管疾病的风险。

关键词: 血栓调节蛋白, 阻塞性睡眠呼吸暂停低通气综合征, 髓过氧化物酶, 发病机制, 心血管损害

Abstract: Objective To investigate the detection and significance of serum thrombomodulin(TM)and myeloperoxidase(MPO)in adults with obstructive sleep apnea hypopnea syndrome(OSAHS). Methods A total of 90 OSAHS patients treated during Mar. 2014 and Feb. 2016 were divided into 3 groups according to apnea hyponea index(AHI): mild group(n=30), moderate group(n=30)and severe group(n=30). Another 30 healthy people served as the control group. The peripheral blood was collected from the patients with fasting blood in the morning after patients received polysomnography(PSG). The serum TM and MPO levels were determined by enzyme-linked immunosorbent assay(ELISA). Patients in the severe group were treated with continuous positive airway pressure(CPAP)and surgery. After 6-8 days, the narrow airway plane was evaluated to determine appropriate approaches of surgery. TM, 山 东 大 学 学 报 (医 学 版)54卷12期 -张红霞,等.成人阻塞性睡眠呼吸暂停低通气综合征外周血TM、MPO的检测及意义 \=- MPO and PSG were repeatedly detected and analyzed. Results The serum TM and MPO levels were positively correlated with the severity of OSAHS(P<0.05). There was no significant difference in TM and MPO levels between the mild OSAHS group and control groups(P>0.05), but there was difference between the moderate and control groups, and between severe and control groups(P<0.05). The BMI of the severe group increased significantly compared with that of the mild, moderate and control groups(P<0.05). There was no correlation between TM and MPO levels and BMI, age and sex(P>0.05). There was positive correlation between TM and MPO levels and AHI(P<0.05), and negative correlation with LsaO2(P<0.05). In the severe OSAHS group, LsaO2 significantly increased after comprehensive treatment, while the TM and MPO levels and AHI significantly decreased(P<0.05). Conclusion Increased peripheral TM and MPO levels are involved in the cardiovascular damage in OSAHS patients. Detection of TM and MPO levels helps to determine the patients condition and efficacy of treatment, and assess the risk of cardiovascular disease.

Key words: Cardiovascular damage, Pathogenesis, Myeloperoxidase, Thrombomodulin, Obstructive sleep apnea hypopnea syndrome

中图分类号: 

  • R762
[1] 张萍, 郭文佳. OSAHS与心血管疾病的研究进展[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(6):442-445. ZHANG Ping, GUO Wenjia. The research progress of OSAHS and cardiovascular disease[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2016, 30(6):442-445.
[2] Feng J, Zhang D, Chen B. Endothelial mechanisms of endothelial dysfunction in patients with obstructive sleep apnea[J]. Sleep Breath, 2012, 16(2):283-294.
[3] 邱承杰, 邱春光, 韩战营, 等. 髓过氧化物酶在急性冠脉综合征危险分层中的作用[J]. 临床荟萃, 2010, 25(7): 5603-5604.
[4] Ramar K, Caples SM. Vascular changes, Cardiovascular disease and obstructive sleep apnea[J]. Future Cardiol, 2011, 7(2):241-249.
[5] 中华耳鼻咽喉科头颈外科杂志编辑委员会, 中华医学会耳鼻咽喉科头颈外科分会咽喉学组. 阻塞性睡眠呼吸暂停低通气综合征诊断和外科治疗指南[J]. 中华耳鼻咽喉头颈外科杂志, 2009, 44(2):95-96.
[6] 王杰, 李莹, 林忠辉, 等. 正压通气与上气道多平面手术治疗OSAHS研究进展[J]. 临床耳鼻咽喉头颈外科杂志, 2013, 27(18):1036-1040.
[7] Liu JN, Zhang JX, Lu G, et al. The effect of oxidative stress in myocardial cell injury in mice exposed to chronic intermittent hypoxia[J]. Chinese Medical Journal, 2010, 123(1):74-78.
[8] 蔡伟, 张秀伟, 张希龙, 等. 阻塞性睡眠呼吸暂停综合征、炎症因子与动脉粥样硬化间关系的研究进展[J]. 东南大学学报(医学版), 2015, 34(1):159-162.
[9] Brostrom A, Sunnergren O, Johansson P, et al. Symptom profile of undiagnosed obstructive sleep apnoea in hypertensive outpatients in primary care: a structural equation model analysis[J]. Qual Prim Care, 2012, 20(4):287-298.
[10] Komarowska H, Jaskula M, Stangierski A, et al. Influence of ghrelin on energy balance and endocrine physiology[J]. Neuro Endocrinol Lett, 2012, 33(8):749-756.
[11] Akinnusi ME, Laporta R, El-Solh AA. Lectin-like oxidized low-density lipoprotein receptor-1 modulates endothelial apoptosis in obstructive sleep apnea[J]. Chest, 2011, 140(6):1503-1510.
[12] 张庆伟, 王春婷, 王启志, 等. 丙酮酸乙酯对脓毒症大鼠小肠黏膜屏障的保护作用及其机制[J]. 山东大学学报(医学版), 2014, 52(5):30-34. ZHANG Qingwei, WANG Chunting, Wang Qizhi, et al. Protective effect and mechanism of ethyl pyruvate on the small intestine barrier in rats with sepsis[J]. Journal of Shandong University(Health Sciences), 2014, 52(5):30-34.
[13] 刘成桂, 彭端亮, 罗俊, 等. 联合检测MPOIL-6和hs-CRP对冠心病危险分层的价值[J]. 第三军医大学学报, 2011, 33(19):2061-2065. LIU Chengjia, PENG Duanliang, LUO Jun, et al. Value of risk stratification of coronary heart disease by combined determination of myeloperoxidase, interleukin-6 and high sensitivity C-reactive protein[J]. Journal of Third Military Medical University, 2011, 33(19):2061-2065.
[14] Heinecke JW. The role of myeloperoxidase in HDL oxidation and atherogenesis[J]. Curr Atheroscler Rep, 2007, 9(4):249-251.
[15] Brennan ML, Pennms MS, Van Lente F, et al. Prognostic value of myeloperoxidase in patients with chest pain[J]. N Engl J Med, 2003, 349(17):1595-1604.
[16] Baldus S, Heeschen C, Meinertz T, et al. Myeloperoxidase serum levels predict risk in patients with acute coronary syndromes[J]. Circulation, 2003, 108(12):1440-1445.
[17] Chung S, Yoon IY, Lee CH, et al. The association of nocturnal hypoxemia with arterial stiffness and endothelial dysfunction in male patients with obstructive sleep apnea syndrome[J]. Respiration, 2010, 79(5):363-369.
[18] Takagi T, Morser J, Gabazza EC, et al. The coagulation and protein C pathways in patients with sleep apnea[J]. Lung, 2009, 187(4):209-213.
[19] 陈亚隽. TM与ICAM-1在阻塞性睡眠呼吸暂停低通气综合征合并高血压中的变化及意义[D]. 武汉: 华中科技大学, 2013.
[20] 郭欣, 吴志宇, 陈春悠. 阻塞性睡眠呼吸暂停低通气综合征中血清髓过氧化酶检测的意义[J]. 临床耳鼻咽喉头颈外科杂志, 2016, 30(6): 455-458.
[1] 杜蘅,袁晓东. 阿尔茨海默病病因及发病机制研究进展[J]. 山东大学学报（医学版）, 2017, 55(10): 21-27.
[2] 闫静，侯瑾，盛颖，王波涛，祝康，康全清. 间歇性缺氧大鼠模型的建立及评价[J]. 山东大学学报(医学版), 2013, 51(06): 53-56.
[3] 高春艳，刘运秋 . 瘦素受体基因Pro1019Pro多态性与阻塞性睡眠呼吸暂停低通气综合征相关性研究[J]. 山东大学学报(医学版), 2012, 50(2): 87-.
[4] 刘维英，余勤，张佳宾，岳红梅，濮家源. OSAHS患者血浆β内啡肽、神经肽Y及脑肠肽Ghrelin水平变化及CPAP干预研究[J]. 山东大学学报(医学版), 2012, 50(1): 89-93.
[5] 丁霞 赵斌 马子堂 贾守勤. 肝门静脉系统栓塞的机制探讨[J]. 山东大学学报(医学版), 2009, 47(5): 106-108.
[6] 张栩1，于文2，管庆波1，赵家军1. 对内皮细胞MCP1表达的影响及二甲双胍的干预研究[J]. 山东大学学报(医学版), 2009, 47(11): 1-5.
[7] 杨雪莉,蔡可丽,高雪,吴晓莉,卓建,杨博,刘德荣,王荣 . 未折叠蛋白应答在晶状体上皮细胞凋亡中的作用[J]. 山东大学学报(医学版), 2008, 46(1): 52-56.
[8] 王媛媛,黎莉,周风华,孟晓,钟明,张薇,张运. 急性冠状动脉综合征患者外周循环中性粒细胞髓过氧化物酶测定的临床意义[J]. 山东大学学报(医学版), 2007, 45(10): 996-999.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
版权所有 © 2018 《山东大学学报(医学版)》编辑部　
地址:山东大学科技期刊社（济南市历城区山大南路27号山东大学中心校区明德楼B座721室） 电话: 0531-88366918 E-mail: xbyxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发