CAJ | 학술논문

目的检测男性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆雌激素水平及其腭扁桃体雌激素受体的表达.方法选取男性OSAHS患者76例为实验组,男性慢性扁桃体炎患者45例为对照组,实验组手术切除扁桃体及腭帆间隙脂肪组织,对照组手术切除扁桃体,化学发光免疫分析法检测两组患者的血浆雌二醇水平,免疫组化方法检测两组患者腭扁桃体中雌激素受体(estrogen receptor,ER)α、β的表达,观察其与患者年龄、打鼾病史、呼吸暂停病史、呼吸暂停低通气指数(AHI)、体质量指数(BMI)、颈围、腹围、血压、吸烟、饮酒、腭咽部狭窄程度、Epworth嗜睡量表(Epworth sleepiness scale score,ESS)评分、合并的全身系统疾病之间的关系.结果实验组与对照组患者的雌二醇水平平均(x±s)分别为(94.94±25.54)和(104.23±34.75) pmol/L,差异无统计学意义(t=1.56,P＞0.05).OSAHS患者血浆雌激素水平与AHI呈正相关(r=0.76,P＜0.01),与BMI、ESS、颈围和腹围呈正相关趋势(r值分别为0.43、0.34、0.31和0.32,P值均＜0.01).实验组ERα和ERβ的表达分别为36.8％和48.7％,低于对照组(分别为60.0％和68.9％),差异有统计学意义(x2值分别为5.17和4.69,P值均＜0.05).OSAHS患者腭扁桃体中ERα、ERβ的表达均与患者AHI呈负相关趋势(r值分别为-0.48和-0.26,P值均＜0.05).OSAHS患者腭扁桃体中ERα的表达与患者最低血氧饱和度呈正相关趋势(r =0.27,P＜0.05).结论雌激素在男性OSAHS患者发病中可能起促进作用.男性OSAHS患者腭扁桃体中ER随病情程度加重而表达减少,可能与缺氧有关.
목적 검측남성조새성수면호흡잠정저통기종합정(OSAHS)환자혈장자격소수평급기악편도체자격소수체적표체.방법 선취남성OSAHS환자76례위실험조,남성만성편도체염환자45례위대조조,실험조수술절제편도체급악범간극지방조직,대조조수술절제편도체,화학발광면역분석법검측량조환자적혈장자이순수평,면역조화방법검측량조환자악편도체중자격소수체(estrogen receptor,ER)α、β적표체,관찰기여환자년령、타한병사、호흡잠정병사、호흡잠정저통기지수(AHI)、체질량지수(BMI)、경위、복위、혈압、흡연、음주、악인부협착정도、Epworth기수량표(Epworth sleepiness scale score,ESS)평분、합병적전신계통질병지간적관계.결과 실험조여대조조환자적자이순수평평균(x±s)분별위(94.94±25.54)화(104.23±34.75) pmol/L,차이무통계학의의(t=1.56,P＞0.05).OSAHS환자혈장자격소수평여AHI정정상관(r=0.76,P＜0.01),여BMI、ESS、경위화복위정정상관추세(r치분별위0.43、0.34、0.31화0.32,P치균＜0.01).실험조ERα화ERβ적표체분별위36.8％화48.7％,저우대조조(분별위60.0％화68.9％),차이유통계학의의(x2치분별위5.17화4.69,P치균＜0.05).OSAHS환자악편도체중ERα、ERβ적표체균여환자AHI정부상관추세(r치분별위-0.48화-0.26,P치균＜0.05).OSAHS환자악편도체중ERα적표체여환자최저혈양포화도정정상관추세(r =0.27,P＜0.05).결론 자격소재남성OSAHS환자발병중가능기촉진작용.남성OSAHS환자악편도체중ER수병정정도가중이표체감소,가능여결양유관.
Objective To detect the plasma estrogen level and estrogen receptors expression in palatine tonsils of male patients with obstructive sleep apnea hypopnea syndrom (OSAHS).Methods Seventy-six patients with OSAHS were selected as experimental group,45 patients with chronic tonsillitis as the control group.The tonsils and adipose tissues in space veli palatin were surgically resected in the experimental group,the tonsils were resected in the control group.The plasma level of estrogen was evaluated in patients of the two groups with chemiluminescence immunoassay respectively.The expression of estrogen receptors (ER alpha,ER beta) in palatine tonsils was detected with immunohistochemical methods in the two groups.The relationships between the expression of estrogen receptors and the patient's age,history of snoring,history of apnea,apnea hypopnea index (AHI),body mass index (BMI),neck circumference,abdominal circumference,blood pressure,smoking,alcohol drinking,the degree of velopharyngeal stenosis,the Epworth sleepiness scale score (ESS),and accompanied systemic diseases were analyzed.Results The estradiol levels did not show significant statistical difference between the two groups [(94.94 ± 25.54) pmol/L,(104.23 ± 34.75) pmol/L,respectively].The estrogen levels in OSAHS patients were positively correlated with the patients' AHI (r =0.76,P ＜ 0.01),showed positively correlated trends with BMI (r =0.43,P＜0.01),ESS (r=0.34,P＜0.01),neck circumference (r =0.31,P=0.01),abdominal circumference (r =0.32,P ＜ 0.01) ; the expressions of ER alpha and ER beta in the experimental group (36.8％,48.7％) were lower than that in the control group (60.0％,68.9％)respectively,the difference was statistically significant (x2 were 5.17 and 4.69,P ＜ 0.05) ; the expressions of ER alpha and beta in OSAHS patients showed negatively correlated trends with the patients' AHI (r =-0.48,P ＜0.01;r =-0.26,P ＜0.05).The expressions of ER alpha in OSAHS patiems showed positively correlated trends with the patients' lowest oxygen saturation.Conelusions Estrogen may promote the occurrence of male OSAHS.The ER expression in palatine tonsils of male OSAHS patients accorded to the severity of illness,may be associated with hypoxia.