重叠综合征患者血浆脂联素和去甲肾上腺素水平的变化及意义

发布时间：2018-06-13 22:45

本文选题：重叠综合征 + 慢性阻塞性肺疾病　；参考：《广东医学》2014年24期

【摘要】：目的通过检测慢性阻塞性肺疾病(COPD)、阻塞性睡眠呼吸暂停低通气综合征(OSAHS)及重叠综合征(OS)患者血浆脂联素和去甲肾上腺素的水平,分析它们与疾病严重程度及血氧的相关性,探讨其在疾病发生发展中的作用。方法通过多导睡眠监测及肺功能筛查160例患者,分为OS组(24例),COPD组(26例),鼾症组(24例),轻度OSAHS组(28例),中度OSAHS组(26例),重度OSAHS组(32例)6组,记录夜间最低血氧饱和度(LSa O2),测量患者颈围、腰围、身高、体重、睡前血压,计算体质指数,比较脂联素、去甲肾上腺素与指标间的相关性。结果 OS组及OSAHS各组患者血浆脂联素较鼾症组明显降低(P0.01),血浆去甲肾上腺素明显升高(P0.01);OSAHS各组间差异均有统计学意义(P0.05);COPD组与中度OSAHS组之间差异无统计学意义(P0.05)。各亚组患者的收缩压差异无统计学意义,OS组、中度及重度OSAHS组舒张压与轻度OSAHS组比较差异有统计学意义(P0.05)。患者血浆脂联素水平与呼吸暂停低通气指数(AHI)呈负相关(r=-0.524,P0.01),与LSa O2呈正相关(r=0.627,P0.01),而血浆去甲肾上腺素与AHI呈正相关(r=0.484,P0.01),与LSa O2呈负相关(r=-0.731,P0.01)。血浆脂联素水平与收缩压、舒张压均无相关性(r=-0.143,P0.05;r=-0.115,P0.05),而血浆去甲肾上腺素与收缩压无相关性(r=0.128,P0.05),与舒张压呈正相关(r=0.240,P0.05)。结论肥胖是引起OS的重要危险因素,血浆脂联素、去甲肾上腺素水平在OS及OSAHS的发病中发挥一定的作用,且随病情的严重程度改变。
[Abstract]:Objective to detect the plasma adiponectin and norepinephrine levels in patients with chronic obstructive pulmonary disease (COPD), obstructive sleep apnea hypopnea syndrome (OSAHS) and overlap syndrome (OS), and to analyze the relationship between plasma adiponectin and norepinephrine. To explore its role in the occurrence and development of disease. Methods 160 patients were divided into OS group (n = 24), snoring group (n = 24), mild OSAHS group (n = 28), moderate OSAHS group (n = 26) and severe OSAHS group (n = 32). The lowest nocturnal oxygen saturation (LSAO _ 2) was recorded. The neck circumference, waist circumference, height, weight, blood pressure before bedtime, body mass index (BMI), adiponectin, norepinephrine (norepinephrine) were measured. Results the plasma adiponectin level in OS group and OSAHS group was significantly lower than that in snoring group. There was no significant difference in plasma norepinephrine between COPD group and moderate OSAHS group. There was no significant difference in systolic blood pressure in all subgroups. There was significant difference in diastolic blood pressure between moderate and severe OSAHS group and mild OSAHS group (P 0.05). There was a negative correlation between plasma adiponectin level and apnea hypopnea index (AHII), a positive correlation between plasma adiponectin level and apnea hypopnea index (AHI), a positive correlation between plasma adiponectin level and apnea hypopnea index (AHI), a positive correlation between plasma adiponectin level and apnea hypopnea index (AHI), a positive correlation between plasma adiponectin level and apnea hypopnea index (AHI), and a positive correlation between plasma adiponectin level and apnea hypopnea index (AHI). There was no correlation between plasma adiponectin level and systolic blood pressure and diastolic blood pressure. There was no correlation between plasma noradrenaline and systolic blood pressure, but there was no correlation between plasma noradrenaline and systolic blood pressure, and there was a positive correlation between plasma noradrenaline and systolic blood pressure, and a positive correlation between plasma noradrenaline and diastolic blood pressure. Conclusion Obesity is an important risk factor for OS. Plasma adiponectin and norepinephrine levels play a role in the pathogenesis of OS and OSAHS, and change with the severity of the disease.
【作者单位】：南昌大学第二附属医院呼吸内科;
【分类号】：R563.9

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