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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

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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
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