中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
24期
2859-2861
,共3页
赵慧新%赵会媛%闫奕%张杏红
趙慧新%趙會媛%閆奕%張杏紅
조혜신%조회원%염혁%장행홍
脑梗死%睡眠呼吸暂停,阻塞性%基质金属蛋白酶9%内-中膜厚度
腦梗死%睡眠呼吸暫停,阻塞性%基質金屬蛋白酶9%內-中膜厚度
뇌경사%수면호흡잠정,조새성%기질금속단백매9%내-중막후도
Cerebral infarction%Sleep apnea,obstructive%Matrix metalloproteinase 9%Intima-media thickness
目的：探讨急性脑梗死（ ACI）合并阻塞性睡眠呼吸暂停低通气综合征（ OSAHS）患者颈动脉内-中膜厚度（IMT）及血清基质金属蛋白酶9（MMP-9）水平的变化。方法选取2012年1月-2013年6月河北大学附属医院住院的ACI患者，均符合第四届全国脑血管病学术会议制订的脑梗死的诊断标准，行多导睡眠图（ PSG）确诊合并OSAHS的患者36例为ACI合并OSAHS组，根据AHI分为轻度组10例、中度组13例、重度组13例；另选择同时期ACI患者经PSG排除OSAHS患者39例为单纯ACI组。患者均行彩色多普勒超声检查，记录颈动脉IMT，酶联免疫吸附试验（ ELISA）法检测血清MMP-9水平。结果 ACI合并OSAHS组患者颈动脉IMT及血清MMP-9水平均高于单纯ACI组（P<0.05）。ACI合并OSAHS组患者颈动脉IMT与血清MMP-9呈正相关（r=0.582，P=0.000）。ACI合并OSAHS患者轻度组、中度组、重度组患者颈动脉IMT及血清MMP-9水平比较，差异有统计学意义（ P<0.05）；其中中度组和重度组颈动脉IMT及血清MMP-9水平高于轻度组（P<0.05）。结论 ACI合并OSAHS患者颈动脉IMT及血清MMP -9水平升高，中、重度组患者升高更明显，且颈动脉 IMT 与血清 MMP -9水平呈正相关， OSAHS可能通过炎症途径促使ACI的发生。
目的：探討急性腦梗死（ ACI）閤併阻塞性睡眠呼吸暫停低通氣綜閤徵（ OSAHS）患者頸動脈內-中膜厚度（IMT）及血清基質金屬蛋白酶9（MMP-9）水平的變化。方法選取2012年1月-2013年6月河北大學附屬醫院住院的ACI患者，均符閤第四屆全國腦血管病學術會議製訂的腦梗死的診斷標準，行多導睡眠圖（ PSG）確診閤併OSAHS的患者36例為ACI閤併OSAHS組，根據AHI分為輕度組10例、中度組13例、重度組13例；另選擇同時期ACI患者經PSG排除OSAHS患者39例為單純ACI組。患者均行綵色多普勒超聲檢查，記錄頸動脈IMT，酶聯免疫吸附試驗（ ELISA）法檢測血清MMP-9水平。結果 ACI閤併OSAHS組患者頸動脈IMT及血清MMP-9水平均高于單純ACI組（P<0.05）。ACI閤併OSAHS組患者頸動脈IMT與血清MMP-9呈正相關（r=0.582，P=0.000）。ACI閤併OSAHS患者輕度組、中度組、重度組患者頸動脈IMT及血清MMP-9水平比較，差異有統計學意義（ P<0.05）；其中中度組和重度組頸動脈IMT及血清MMP-9水平高于輕度組（P<0.05）。結論 ACI閤併OSAHS患者頸動脈IMT及血清MMP -9水平升高，中、重度組患者升高更明顯，且頸動脈 IMT 與血清 MMP -9水平呈正相關， OSAHS可能通過炎癥途徑促使ACI的髮生。
목적：탐토급성뇌경사（ ACI）합병조새성수면호흡잠정저통기종합정（ OSAHS）환자경동맥내-중막후도（IMT）급혈청기질금속단백매9（MMP-9）수평적변화。방법선취2012년1월-2013년6월하북대학부속의원주원적ACI환자，균부합제사계전국뇌혈관병학술회의제정적뇌경사적진단표준，행다도수면도（ PSG）학진합병OSAHS적환자36례위ACI합병OSAHS조，근거AHI분위경도조10례、중도조13례、중도조13례；령선택동시기ACI환자경PSG배제OSAHS환자39례위단순ACI조。환자균행채색다보륵초성검사，기록경동맥IMT，매련면역흡부시험（ ELISA）법검측혈청MMP-9수평。결과 ACI합병OSAHS조환자경동맥IMT급혈청MMP-9수평균고우단순ACI조（P<0.05）。ACI합병OSAHS조환자경동맥IMT여혈청MMP-9정정상관（r=0.582，P=0.000）。ACI합병OSAHS환자경도조、중도조、중도조환자경동맥IMT급혈청MMP-9수평비교，차이유통계학의의（ P<0.05）；기중중도조화중도조경동맥IMT급혈청MMP-9수평고우경도조（P<0.05）。결론 ACI합병OSAHS환자경동맥IMT급혈청MMP -9수평승고，중、중도조환자승고경명현，차경동맥 IMT 여혈청 MMP -9수평정정상관， OSAHS가능통과염증도경촉사ACI적발생。
Objective To investigate the changes of carotid intima-media thickness( IMT)and serum MMP-9 in a-cute cerebral infarction(ACI)combined with obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods ACI patients admitted to the Affiliated Hospital of Hebei University from January 2012 to June 2013 were selected. All the patients met the diag-nostic criteria for infarction established in the Fourth National Cerebrovascular Disease Seminar. 36 cases were confirmed with OSAHS by PSG,and were then included in the ACI combined with OSAHS group. According to the severity of AHI,the patients were divided into mild group(10 cases),moderate group(13 cases)and severe group(13 cases). Another 39 ACI patients without OSAHS were included in the ACI alone group. All cases were given color Doppler ultrasound to record IMT,and ELISA was used to detect the serum MMP-9 level. Results The IMT and serum MMP-9 levels of ACI patients combined with OSAHS were both higher than those of patients with ACI alone( P<0. 05 ) . The IMT was positively correlated with serum MMP-9 in ACI patients combined with OSAHS(r=0. 582,P=0. 000). The IMT and serum MMP-9 levels of the mild,moderate and severe groups of ACI patients combined with OSAHS showed statistically significant differences(P<0. 05). The IMT and serum MMP-9 levels of the moderate and severe groups were higher than the mild group(P<0. 05). Conclusion The IMT and ser-um MMP-9 levels in ACI patients combined with OSAHS are higher,especially in moderate and severe groups. The IMT is posi-tively correlated with serum MMP-9 level,and OSAHS may cause the occurrence of ACI in the way of inflammation.
