阻塞性睡眠呼吸暂停低通气综合征患者醛固酮与肺泡表面活性物质相关蛋白水平的关系

发布时间：2018-01-26 10:52

本文关键词： 阻塞性睡眠呼吸暂停低通气综合征醛固酮肺泡表面活性物质相关蛋白　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者血浆醛固酮浓度(plasma aldosterone concentration,PAC)和血清肺表面活性物质相关蛋白(SPs)水平的关系。方法:本研究为横断面研究,选取2013年4月至2013年12月在新疆维吾尔自治区人民医院高血压诊疗研究中心住院的OSAHS患者共86人。所有入选患者均行睡眠呼吸监测(Polysomnography,PSG),查晨起坐位血浆醛固酮浓度,采用酶联免疫吸附方法(ELISA)测定血清肺泡表面活性物质相关蛋白(SPs,包括SP-A,SP-B,SP-C,SP-D)和涎液化糖链抗原(KL-6)浓度,并根据血浆醛固酮浓度水平分为高醛固酮(H-ALD)组(n=32)(PAC≥15ng/dl)和正常醛固酮(N-ALD)组(n=54)(PAC15ng/dl)。探讨H-ALD组与N-ALD组的血浆醛固酮浓度和血清肺表面活性物质相关蛋白水平的关系。结果:与N-ALD组相比,H-ALD组血清SP-B较低(40.10±5.76ng/L比43.16±6.89ng/L,P=0.038),血清SP-A/C/D水平在H-ALD组中均有下降趋势,但未达到统计学意义,两组间KL-6水平见到统计学意义的差异。相关分析显示,控制呼吸暂停低通气指数(apnea-hypopnea index,AHI)后,PAC与血清SP-B呈负相关(r=-0.361,P=0.043)。多元线性回归分析显示,PAC是血清SP-B的影响因素(t=-2.081,P=0.041)。结论:在OSAHS患者中,外周血清肺泡表面活性物质相关蛋白SP-B下降可能与升高的血浆醛固酮浓度有关。升高的醛固酮可能会抑制肺泡内SP-B的合成和分泌,表现为血清SP-B水平的下降。
[Abstract]:Objective: to investigate obstructive sleep apnea hypopnea syndrome in obstructive sleep apnea hypopnea syndrome. Plasma aldosterone concentration and plasma aldosterone concentration in patients with OSAHS. Methods: this study was a cross-sectional study. A total of 86 OSAHS patients were selected from April 2013 to December 2013 in the hypertension diagnosis and treatment research center of Xinjiang Uygur Autonomous region people's Hospital. Polysomnography. The plasma aldosterone concentration in the sitting position of PSG was investigated and the serum levels of pulmonary surfactant associated protein (SPsincluding SP-An SP-B) were determined by enzyme linked immunosorbent assay (Elisa). SP-Con SP-D) and salivary liquefaction sugar chain antigen (KL-6). According to the plasma aldosterone concentration, the plasma aldosterone concentration was divided into two groups: the high aldosterone H-ALD group and the normal aldosterone N-ALD group. To investigate the relationship between plasma aldosterone concentration and pulmonary surfactant related protein level in H-ALD group and N-ALD group. Results: compared with N-ALD group. The serum SP-B in H-ALD group was 40.10 卤5.76ng / L vs 43.16 卤6.89ng / L respectively. The level of serum SP-A/C/D decreased in H-ALD group, but did not reach statistical significance. There was a statistically significant difference between the two groups in the level of KL-6. After controlling apnea hypopnea index (apnea-hypopnea index), there was a negative correlation between SP-B and serum SP-B. The multivariate linear regression analysis showed that SP-B was the influential factor of serum SP-B. Conclusion: in patients with OSAHS, there is no significant difference between the two factors (P < 0. 043, P = 0. 043, P = 0. 043, P < 0. 043). The decrease of SP-B may be related to the increase of plasma aldosterone concentration, which may inhibit the synthesis and secretion of SP-B in the alveolar. The serum SP-B level decreased.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R766

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