CAJ | 학술논문

目的观察子痫前期合并阻塞性睡眠呼吸暂停(OSA)患者的血清IL-18水平,通过持续气道正压通气(CPAP)观察IL-18的改变.方法纳入2008年8月至2010年8月常州市妇幼保健医院行多导睡眠监测(PSG)及常规孕期体检的妊娠妇女,孕期24～40周,年龄23～40岁,其中AHI＜5次/h的健康妊娠妇女18名(健康对照组),AHI＜5次/h的子痫前期患者18例(单纯子痫组),AHI≥5次/h的子痫前期患者16例(子痫合并OSA组),其中6例AHI≥15次/h,行持续气道正压通气(CPAP)治疗1周(治疗组).采用ELISA法测定血清IL-18水平并比较各组及治疗前后的差异.结果健康对照组、单纯子痫组及子痫合并OSA组血清IL-18水平为(261±95)、( 382±121)和(601±89) ng/L,各组间差异均有统计学意义(均P＜0.01).治疗组患者CPAP治疗后,AHI、收缩压及血清IL-18水平均降低,最低脉氧饱和度明显升高(均P＜0.01),舒张压明显下降(P＞0.05).结论子痫前期合并OSA患者IL-18水平较高,提示OSA可能诱导和加重机体更强的炎症反应而增加子痫前期的发病率,经CPAP治疗有效.
목적 관찰자간전기합병조새성수면호흡잠정(OSA)환자적혈청IL-18수평,통과지속기도정압통기(CPAP)관찰IL-18적개변.방법 납입2008년8월지2010년8월상주시부유보건의원행다도수면감측(PSG)급상규잉기체검적임신부녀,잉기24～40주,년령23～40세,기중AHI＜5차/h적건강임신부녀18명(건강대조조),AHI＜5차/h적자간전기환자18례(단순자간조),AHI≥5차/h적자간전기환자16례(자간합병OSA조),기중6례AHI≥15차/h,행지속기도정압통기(CPAP)치료1주(치료조).채용ELISA법측정혈청IL-18수평병비교각조급치료전후적차이.결과 건강대조조、단순자간조급자간합병OSA조혈청IL-18수평위(261±95)、( 382±121)화(601±89) ng/L,각조간차이균유통계학의의(균P＜0.01).치료조환자CPAP치료후,AHI、수축압급혈청IL-18수평균강저,최저맥양포화도명현승고(균P＜0.01),서장압명현하강(P＞0.05).결론 자간전기합병OSA환자IL-18수평교고,제시OSA가능유도화가중궤체경강적염증반응이증가자간전기적발병솔,경CPAP치료유효.
Objective To investigate the role of IL-18 in the obstructive sleep apnea syndrome (OSAS)-induced preeclampsia (PE),by comparison of the changes of serum IL-18 levels among different groups as well as before and after continuous positive airway pressure (CPAP) treatment in pregnant women with both OSAS and PE.Methods In control group there were 18 normal pregnant women with apnea hypopnea index (AHI) ＜5.In simple PE group 18 pregnant PE patients with an AHI ＜5 were recruited.In PE plus OSAS group 16 PE patients with coexisting OSAS were collected.CPAP treatment was performed for I week in 6 patients with AHI ＞ 15 from PE plus OSAS group.Serum IL-18 levels were measured with ELISA.Result There was a significant difference in serum IL-18 levels among control group [ (261 ±95)ng/L],simple PE group [ ( 382 ± 121 ) ng/L],and PE plus OSAS group [ (601 ± 89 ) ng/L,all P ＜0.001 ].Following CPAP treatment,there was a significant decrease in AHI,systolic blood pressures,and serum IL-18 levels,but a significant increase in minimal SpO2 ( P ＜ 0.01 ).Conclusion Our study demonstrated that serum IL-18 levels in PE patients with OSAS were significantly elevated,which suggested that OSAS might increase the incidence of PE by enhancing inflammatory response,while CPAP treatment could effectively improve the pathological process.