CAJ | 학술논문

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆抵抗素水平的变化及临床意义.方法采用酶联免疫吸附试验(ELISA)测定30例伴有肥胖的OSAHS患者(肥胖OSAHS组,其中轻、中、重度OSAHS各为7、9、14例)、30例单纯性肥胖者(单纯肥胖组)和28名健康成人(正常对照组)的血浆抵抗素水平,并分析血浆抵抗素水平与体重指数、腰臀比、血糖、血脂、睡眠呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO2)等指标的相关性.结果肥胖OSAHS组、单纯肥胖组、正常对照组血浆抵抗素分别为(8.48±1.44)、(7.60±1.53)、(5.78±1.62)μg/L,肥胖OSAHS组明显高于单纯肥胖组和正常对照组(均P＜0.05),单纯肥胖组明显高于正常对照组(P＜0.05).肥胖OSAHS组内,轻、中、重度OSAHS患者血浆抵抗素分别为(6.90±1.31)、(7.96±1.06)、(9.60±0.51)μg/L,重度患者明显高于轻度和中度患者(均P＜0.01).血浆抵抗素水平与体重指数、颈围、腰围、腰臀比、空腹血糖、总胆固醇、甘油三酯、AHI呈正相关(r值分别为0.52、0.66、0.74、0.52、0.59、0.48、0.46、0.80,均P＜0.05),与高密度脂蛋白、LSaO2呈负相关(r=-0.52,P＜0.01;r=-0.60.P＜0.05).多元逐步回归分析显示AHI为影响肥胖OSAHS组患者血浆抵抗素水平的最为显著的因素(R2=0.618).结论肥胖OSAHS患者血浆抵抗素水平明显升高,并与AHI呈正相关.血浆抵抗素水平可望作为判断肥胖OSAHS患者病情严重程度的生物学指标.
목적 탐토조새성수면호흡잠정저통기종합정(OSAHS)환자혈장저항소수평적변화급림상의의.방법 채용매련면역흡부시험(ELISA)측정30례반유비반적OSAHS환자(비반OSAHS조,기중경、중、중도OSAHS각위7、9、14례)、30례단순성비반자(단순비반조)화28명건강성인(정상대조조)적혈장저항소수평,병분석혈장저항소수평여체중지수、요둔비、혈당、혈지、수면호흡잠정저통기지수(AHI)、최저혈양포화도(LSaO2)등지표적상관성.결과 비반OSAHS조、단순비반조、정상대조조혈장저항소분별위(8.48±1.44)、(7.60±1.53)、(5.78±1.62)μg/L,비반OSAHS조명현고우단순비반조화정상대조조(균P＜0.05),단순비반조명현고우정상대조조(P＜0.05).비반OSAHS조내,경、중、중도OSAHS환자혈장저항소분별위(6.90±1.31)、(7.96±1.06)、(9.60±0.51)μg/L,중도환자명현고우경도화중도환자(균P＜0.01).혈장저항소수평여체중지수、경위、요위、요둔비、공복혈당、총담고순、감유삼지、AHI정정상관(r치분별위0.52、0.66、0.74、0.52、0.59、0.48、0.46、0.80,균P＜0.05),여고밀도지단백、LSaO2정부상관(r=-0.52,P＜0.01;r=-0.60.P＜0.05).다원축보회귀분석현시AHI위영향비반OSAHS조환자혈장저항소수평적최위현저적인소(R2=0.618).결론 비반OSAHS환자혈장저항소수평명현승고,병여AHI정정상관.혈장저항소수평가망작위판단비반OSAHS환자병정엄중정도적생물학지표.
Objective To explore the changes and clinical implications of plasma resisfin level in obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Plasma resistin level was measured by radioimmunoassay in 30 obese OSAHS patients (obese OSAHS group), 7 in the low apnea hypopnea index (AHI) subgroup, 9 in the medium AHI subgroup, and 14 in the high AHI subgroup, 30 obese subjects (obese group), and 28 normal healthy adults (control group). Stepwise multiple linear regression analysis was conducted to determine the correlation of plasma resistin level with body mass index (BMI), body fat percentage, waist to hip ratio (WHR), fasting blood glucose (FBG), blood lipid, AHI, and lowest arterial oxygen saturation (LSaO2). Results The plasma resistin levels of the obese OSAHS group and obese group were (8.48 ± 1.44) and (7.60 ± 1.53) μg/L respectively, both significantly higher than that of the control group [(5.78 ± 1.62) μg/L, both P＜0.05], and that of the obese OSAHS group was significantly higher than that of the obese group (P＜0.05). The plasma resisfin level of the high AHI obese OSAHS subgroup was (9.60 ±0.51) μg/L, significantly higher than those of the medium and low AHI obese OSAHS subgroups [ (7.96 ± 1.06) and (6.90 ± 1.32) μg/L respectively, both P＜0.01]. Correlation analysis demonstrated that the fasting plasma resistin level was positively eorrelated with BMI, neck circumference, waist circumference, WHR, FBG, total cholesterol, triglyceride, and AHI (r = 0.52, 0.66, 0.74, 0.52, 0.59, 0.48, 0.46, and 0.80, all P＜0.05) ; and negatively correlated with high-density hpoprotein cholesterol and LSaO2 ( r = - 0.52, r = - 0. 60, both P＜0.01). A stepwise multiple linear regression analysis showed that AHI was the most significant contributing factor for the increased plasma resistin level in the obese OSAHS group (R2 = 0.618). Conclusions Plasma resistin level in obese OSAHS patients are increased, and are positively correlated with AHI. It may be used as an important biological index to evaluate the severity of OSAHS.