CAJ | 학술논문

目的：检测肥胖和正常体质量的阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者及非OSAHS患者血浆透明质酸、Ⅲ型前胶原、Ⅳ型胶原和层黏连蛋白水平，探讨OSAHS与肝纤维化的关系。方法选取2010年12月-2013年6月在我院门诊和住院确诊为OSAHS的患者52例，按照体质指数（BMI）分为肥胖合并OSAHS组27例、正常体质量OSAHS组25例，另外选取同期门诊及住院行多导睡眠图（PSG）检查排除OSAHS的单纯肥胖者30例为单纯肥胖组，正常体质量者30例为对照组。检测所有受试者的 BMI、呼吸暂停低通气指数（ AHI）、最低血氧饱和度（LSaO2）、平均血氧饱和度（MSaO2）等睡眠呼吸指标，均在 PSG 检查的次日早晨抽血送我院生化实验室测定血浆透明质酸、Ⅲ型前胶原、Ⅳ型胶原和层黏连蛋白水平。结果4组血浆透明质酸、Ⅲ型前胶原、Ⅳ型胶原和层黏连蛋白水平比较，差异均有统计学意义（ P <0.05）；其中与对照组比较，单纯肥胖组、正常体质量OSAHS组、肥胖合并OSAHS组以上几项指标均升高（P <0.05）；与单纯肥胖组比较，正常体质量OSAHS组、肥胖合并OSAHS组以上几项指标均升高（P <0.05）；与正常体质量OSAHS组比较，肥胖合并OSAHS组以上几项指标均升高（P <0.05）。OSAHS患者血浆透明质酸、Ⅲ型前胶原、Ⅳ型胶原和层黏连蛋白水平与 AHI 和 BMI 均呈正相关（P <0.05），与 LSaO2和MSaO2均呈负相关（P <0.05）。结论 OSAHS患者血浆透明质酸、Ⅲ型前胶原、Ⅳ型胶原和层黏连蛋白水平与 AHI 和 BMI 相关，OSAHS可能导致肝纤维化。
목적：검측비반화정상체질량적조새성수면호흡잠정저통기종합정（OSAHS）환자급비OSAHS환자혈장투명질산、Ⅲ형전효원、Ⅳ형효원화층점련단백수평，탐토OSAHS여간섬유화적관계。방법선취2010년12월-2013년6월재아원문진화주원학진위OSAHS적환자52례，안조체질지수（BMI）분위비반합병OSAHS조27례、정상체질량OSAHS조25례，령외선취동기문진급주원행다도수면도（PSG）검사배제OSAHS적단순비반자30례위단순비반조，정상체질량자30례위대조조。검측소유수시자적 BMI、호흡잠정저통기지수（ AHI）、최저혈양포화도（LSaO2）、평균혈양포화도（MSaO2）등수면호흡지표，균재 PSG 검사적차일조신추혈송아원생화실험실측정혈장투명질산、Ⅲ형전효원、Ⅳ형효원화층점련단백수평。결과4조혈장투명질산、Ⅲ형전효원、Ⅳ형효원화층점련단백수평비교，차이균유통계학의의（ P <0.05）；기중여대조조비교，단순비반조、정상체질량OSAHS조、비반합병OSAHS조이상궤항지표균승고（P <0.05）；여단순비반조비교，정상체질량OSAHS조、비반합병OSAHS조이상궤항지표균승고（P <0.05）；여정상체질량OSAHS조비교，비반합병OSAHS조이상궤항지표균승고（P <0.05）。OSAHS환자혈장투명질산、Ⅲ형전효원、Ⅳ형효원화층점련단백수평여 AHI 화 BMI 균정정상관（P <0.05），여 LSaO2화MSaO2균정부상관（P <0.05）。결론 OSAHS환자혈장투명질산、Ⅲ형전효원、Ⅳ형효원화층점련단백수평여 AHI 화 BMI 상관，OSAHS가능도치간섬유화。
Objective To detect the levels of plasma hyaluronic acid,procollagen Ⅲ,collagen Ⅳ and laminin and to investigate the relationship between OSAHS and hepatic fibrosis. Methods 52 inpatients and outpatients admitted to our hospital from December 2010 to June 2013 were selected. Based on the BMI,the patients were divided into obesity + OSAHS group(27 cases),normal BMI + OSAHS group(25 cases). 30 cases who underwent PSG and were excluded from OSAHS were selected as obesity group,and 30 people with normal BMI were selected as control group. The BMI,AHI,LSaO2 and MSaO2 of all the groups were detected,and the levels of plasma hyaluronic acid,procollagen Ⅲ,collagen Ⅳ and laminin were also detected one day after PSG examination. Results The levels of plasma hyaluronic acid,procollagen Ⅲ,collagen Ⅳ and laminin in the four groups showed statistically significant difference(P < 0. 05). Compared with the control group,the above mentioned indicators in obesity group,normal BMI + OSAHS group and obesity + OSAHS group were all higher(P < 0. 05);compared with the obesi-ty group,the above mentioned indicators in normal BMI + OSAHS group and obesity + OSAHS group were also higher( P <0. 05);compared with normal BMI + OSAHS group,the above mentioned indicators were in obesity + OSAHS group were higher (P < 0. 05). The levels of plasma hyaluronic acid,procollagen Ⅲ,collagen Ⅳ and laminin were positively correlated with AHI and BMI(P < 0. 05),but were negatively correlated with LSaO2 and MSaO2(P < 0. 05). Conclusion The levels of plasma hyaluronic acid,procollagen Ⅲ,collagen Ⅳ and laminin were positively correlated with AHI and BMI and OSAHS could lead to hepatic fibrosis.