CAJ | 학술논문

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)非肥胖患者血清高敏C反应蛋白(hs-CRP)水平变化情况.方法收集从2011年7月至2012年6月来福建医科大学附属第一医院睡眠疾病诊治中心行睡眠呼吸监测的非肥胖患者体质量指数(BMI)＜ 25 kg/m2,根据呼吸暂停低通气指数(AHI)将其分为非OSAHS组及轻、中、重度OSAHS组,比较各组性别、年龄、BMI、嗜睡量表(ESS)评分、平均血氧饱和度、呼吸暂停低通气指数(AHI)、最低血氧饱和度及hs-CRP水平.结果共收集了65例患者,男53例,女12例,平均年龄(44.3±12.2)岁,其中非OSAHS组17例,OSAHS组48例.两组间性别、年龄、BMI、ESS评分、平均血氧饱和度的差异均无统计学意义(均P＞0.05),AHI、最低血氧饱和度的差异均有统计学意义(均P＜0.01),两组间血清hs-CRP水平的差异有统计学意义(P=0.03).与非OSAHS组相比较,轻、中度OSAHS组hs-CRP水平差异无统计学意义,重度OSAHS组hs-CRP水平升高差异有统计学意义(P=0.004).血清hs-CRP与各因素的Pearson相关分析显示,hs-CRP水平与AHI呈正相关关系,r为0.407(P=0.001)；与年龄、BMI、ESS评分、最低血氧饱和度、平均血氧饱和度的相关性差异无统计学意义(P＞0.05).以hs-CRP为因变量做多元逐步回归分析显示,只有AHI是hs-CRP水平升高的可靠预测因子(R2=0.166,P=0.001).结论非肥胖OSAHS患者的血清hs-CRP水平升高,hs-CRP水平升高与OSAHS的严重程度相关.
목적 탐토조새성수면호흡잠정저통기종합정(OSAHS)비비반환자혈청고민C반응단백(hs-CRP)수평변화정황.방법 수집종2011년7월지2012년6월래복건의과대학부속제일의원수면질병진치중심행수면호흡감측적비비반환자체질량지수(BMI)＜ 25 kg/m2,근거호흡잠정저통기지수(AHI)장기분위비OSAHS조급경、중、중도OSAHS조,비교각조성별、년령、BMI、기수량표(ESS)평분、평균혈양포화도、호흡잠정저통기지수(AHI)、최저혈양포화도급hs-CRP수평.결과 공수집료65례환자,남53례,녀12례,평균년령(44.3±12.2)세,기중비OSAHS조17례,OSAHS조48례.량조간성별、년령、BMI、ESS평분、평균혈양포화도적차이균무통계학의의(균P＞0.05),AHI、최저혈양포화도적차이균유통계학의의(균P＜0.01),량조간혈청hs-CRP수평적차이유통계학의의(P=0.03).여비OSAHS조상비교,경、중도OSAHS조hs-CRP수평차이무통계학의의,중도OSAHS조hs-CRP수평승고차이유통계학의의(P=0.004).혈청hs-CRP여각인소적Pearson상관분석현시,hs-CRP수평여AHI정정상관관계,r위0.407(P=0.001)；여년령、BMI、ESS평분、최저혈양포화도、평균혈양포화도적상관성차이무통계학의의(P＞0.05).이hs-CRP위인변량주다원축보회귀분석현시,지유AHI시hs-CRP수평승고적가고예측인자(R2=0.166,P=0.001).결론 비비반OSAHS환자적혈청hs-CRP수평승고,hs-CRP수평승고여OSAHS적엄중정도상관.
Objective To evaluate the relationship between high sensitivity C-reactive protein (hsCRP) level and the severity of obstructive sleep apnea-hypopnea syndrome (OSAHS) in non-obese patients.Methods A total of 65 patients with suspected OSAHS were recruited.Those with a history of cardiovascular or cerebrovascular events,arterial hypertension,chronic obstructive pulmonary disease,diabetes mellitus and smoking were excluded.All subjects were examined by polysomnography.Subjects with an apnea-hypopnea index (AHI) ≥5 were considered to have OSAHS.They were divided into mild,moderate and severe OSAHS groups and those with an AHI ＜ 5 were accepted into the control group.The serum level of hs-CRP,a biomarker for cardiovascular disease,was measured with peripheral venous blood samples.Results There were 53 males and 12 females with a mean age 44.3 ± 12.2 years and a body mass index (BMI) ＜ 25 kg/m2.The serum levels of hs-CRP were significantly higher in OSAHS patients than those of the controls (geometric mean [95％ confidence interval] 0.416 [0.288-0.600] vs 0.749 [0.559-1.003] mg/L,P ＜ 0.05).Mean levels of hs-CRP did not differ between the group with mild-tomoderate OSAHS and the control group.However,the severe OSAHS group had a higher level of hs-CRP than the control group (P =0.004).A significant positive relationship existed between hs-CRP and AHI (r =0.407,P =0.001).According to stepwise multivariate analysis,only AHI was a reliable predictor for elevated serum level of hs-CRP among all these related factors (R2 =0.166,P =0.001).Conclusion The severity of OSAHS is associated with an elevated serum level of hs-CRP in non-obese patients.