CAJ | 학술논문

目的：观察合并阻塞性睡眠呼吸暂停低通气综合征（ OSAHS）的帕金森病患者血清胱抑素C水平的变化，并探讨影响其变化的因素。方法收集2011年7月至2013年12月在苏州大学附属第二医院神经内科就诊并完成多导睡眠监测的帕金森病患者56例，选取同时间段内完成多导睡眠监测的健康中老年人18名作为对照。根据呼吸暂停低通气指数（ AHI）将56例帕金森病患者分成2组：帕金森病合并OSAHS组（n＝26）和帕金森病组（n＝30）。对所有研究对象进行一般情况、运动功能、生化指标、睡眠参数方面的检测，采用SPSS 17.0软件分析并比较3组间上述指标间差异是否有统计学意义。结果帕金森病合并OSAHS组的血清胱抑素C平均水平为（1.05±0.17） mg/L，帕金森病组为（0.96±0.12） mg/L，健康对照组为（0.84±0.20） mg/L，组间比较差异有统计学意义（F＝9.184，P＜0.05）。在帕金森病合并OSAHS组中，斯皮尔曼等级相关分析提示胱抑素C水平与肌酐（r＝0.459，P＝0.018）、尿素（r＝0.405，P＝0.040）、AHI（r＝0.482，P＝0.013）、氧减指数（r＝0.408，P＝0.038）、呼吸相关微觉醒指数（r＝0.392，P＝0.047）、Hoehn-Yahr（H-Y）分级（r＝0.467， P＝0.016）之间呈正相关，与其他临床指标没有相关性（P＞0.05）。线性回归提示肌酐（B＝0.007， P＝0.005）、AHI（B＝0.004，P＝0.013）、H-Y分级（B＝0.102，P＝0.026）是帕金森病患者血清胱抑素C水平变化的重要影响因素。结论帕金森病患者血清胱抑素C水平升高，而合并OSAHS的帕金森病患者胱抑素C水平更高，其水平与夜间低氧程度和帕金森病的严重程度有关。
목적：관찰합병조새성수면호흡잠정저통기종합정（ OSAHS）적파금삼병환자혈청광억소C수평적변화，병탐토영향기변화적인소。방법수집2011년7월지2013년12월재소주대학부속제이의원신경내과취진병완성다도수면감측적파금삼병환자56례，선취동시간단내완성다도수면감측적건강중노년인18명작위대조。근거호흡잠정저통기지수（ AHI）장56례파금삼병환자분성2조：파금삼병합병OSAHS조（n＝26）화파금삼병조（n＝30）。대소유연구대상진행일반정황、운동공능、생화지표、수면삼수방면적검측，채용SPSS 17.0연건분석병비교3조간상술지표간차이시부유통계학의의。결과파금삼병합병OSAHS조적혈청광억소C평균수평위（1.05±0.17） mg/L，파금삼병조위（0.96±0.12） mg/L，건강대조조위（0.84±0.20） mg/L，조간비교차이유통계학의의（F＝9.184，P＜0.05）。재파금삼병합병OSAHS조중，사피이만등급상관분석제시광억소C수평여기항（r＝0.459，P＝0.018）、뇨소（r＝0.405，P＝0.040）、AHI（r＝0.482，P＝0.013）、양감지수（r＝0.408，P＝0.038）、호흡상관미각성지수（r＝0.392，P＝0.047）、Hoehn-Yahr（H-Y）분급（r＝0.467， P＝0.016）지간정정상관，여기타림상지표몰유상관성（P＞0.05）。선성회귀제시기항（B＝0.007， P＝0.005）、AHI（B＝0.004，P＝0.013）、H-Y분급（B＝0.102，P＝0.026）시파금삼병환자혈청광억소C수평변화적중요영향인소。결론파금삼병환자혈청광억소C수평승고，이합병OSAHS적파금삼병환자광억소C수평경고，기수평여야간저양정도화파금삼병적엄중정도유관。
Objective To detect the change of serum cystatine C ( cys C ) level in Parkinson ’ s disease ( PD ) patients with obstructive sleep apnea-hypopnea syndrome ( OSAHS ) and explore its influencing factors .Methods Fifty-six PD patients with polysomnography examination from July 2011 to December 2013 in the Department of Neurology , the Second Affiliated Hospital of Soochow University were collected.Eighteen healthy controls who took the polysomnography examination during the same period were included.According to the apnea-hypopnea index ( AHI) , PD patients were further divided into two groups:PD with OSAHS group ( n=26 ) , and PD group ( n=30 ).The general conditions , movement function , biochemistry parameters , and sleep parameters were assessed.Statistical analysis was performed using SPSS ver 17.0 software.Results The mean serum levels of cys C in PD with OSAHS group , PD group and control group were (1.05 ±0.17) mg/L, (0.96 ±0.12) mg/L and (0.84 ±0.20) mg/L, respectively.Statistical analysis showed that there was significant difference in the three groups (F=9.184,P<0.05), and the mean serum level of cys C in PD with OSAHS group was the highest.In PD with OSAHS group , Spearman correlation analysis showed a positive and significant correlation between cys C levels and creatinine levels (r=0.459,P =0.018), urea levels (r =0.405,P =0.040), AHI (r =0.482,P =0.013), the oxygen desaturation index (r=0.408,P=0.038), the arousal index (r=0.392,P=0.047) as well as Hoehn and Yahr (H-Y) stage (r=0.467,P=0.016).Correlation was not observed between cys C levels and other clinical parameters (P>0.05).Multivariate analysis showed that creatinine levels (B=0.007,P=0.005), AHI (B=0.004,P=0.013) , H-Y stage (B=0.102,P=0.026) may be influencing factors of cys C levels in PD patients (P<0.05).Conclusions Cys C level is elevated in PD patients, especially in PD patients with OSAHS.The degree of hypoxia and severity of PD is related to the level of cys C in PD patients with OSAHS .