阻塞性睡眠呼吸暂停低通气综合征患者血清HIF-1α、HIF-2α水平及其意义

发布时间：2018-05-08 05:24

  本文选题：阻塞性睡眠呼吸暂停低通气综合征 + 低氧诱导因子-1α　； 参考：《青海大学》2017年硕士论文

【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)患者与健康对照组血清低氧诱导因子-1α(hypoxic inducible factor-1α,HIF-1α)、低氧诱导因子-2α(hypoxic inducible factor-2α,HIF-2α)的表达水平差异,进一步了解OSAHS人群在慢性间歇性低氧下血清HIF-1α、HIF-2α的水平变化及其意义。方法:选取2015年12月~2016年12月在青海大学附属医院呼吸内科睡眠监测室行多导睡眠监测(polysomnography,PSG)检查后确诊为OSAHS的西宁地区汉族男性患者为病例组,共41例。对照组选取在我院体检中心体检结果正常的健康男性,详细询问病史,严格按照纳入标准及排除标准并经PSG检查排除睡眠疾患,在年龄、性别、居住海拔等一般情况上与病例组相匹配,共32例。于清晨空腹收集外周静脉血,采用定量酶联免疫吸附试验法检测血清中HIF-1α、HIF-2α的浓度。结果:1.OSAHS组呼吸暂停低通气指数、氧减指数、氧饱和度低于90%所累积时间占总睡眠时间百分比均显著高于对照组(P0.001),分别为([57.8(29.9,70.8)]次/h vs.[1.5(1.0,2.3)]次/h)、([59.4(33.3,75.7)]次/h vs.[3.0(1.5,5.2)]次/h)、([84.0(37.8,95.9)]%vs.[1.7(0.4,12.4)]%);而平均氧饱和度、最低氧饱和度、清晨氧饱和度均显著低于对照组(P0.001),分别为([87.0(83.0,89.5)]%vs.[92.0(91.0,92.8)]%)、([65.0(54.5,72.5)]%vs.[85.5(83.3,86.0)]%)、([90.0(88.5,92.0)]%vs.[94.0(93.0,96.0)]%)。2.OSAHS组与对照组间清晨血清中HIF-1α与HIF-2α表达水平无显著差异(P0.05),分别为([21.357(15.330,23.446)]pg/m L vs.[19.016(13.274,22.812)]pg/m L)、([52.121(30.932,57.003)]pg/m L vs.[41.642(36.242,44.841)]pg/m L)。3.OSAHS患者血清HIF-1α与HIF-2α表达水平与呼吸暂停低通气指数、平均氧饱和度、最低氧饱和度、氧饱和度低于90%所累积时间占总睡眠时间百分比、清晨氧饱和度均无线性相关关系(P0.05)。结论:OSAHS患者与对照组清晨血清HIF-1α与HIF-2α水平无显著差异,考虑间歇低氧状态下HIF-1α与HIF-2α的变化可能为脉冲式,清晨氧饱和度水平不足以刺激HIF-1α与HIF-2α改变,也提示OSAHS患者清晨醒时的血清不能充分反映OSAHS夜间间歇低氧的相关变化。
[Abstract]:Objective: to investigate the difference of serum hypoxia inducible factor 1 伪 peroxia inducible factor-1 伪 (HIF-1 伪), hypoxia inducible factor 2 伪 peroxic inducible factor-2 伪 (HIF-2 伪) in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) and healthy control group, and to investigate the expression of HIF-2 伪 in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). To study the changes and significance of serum HIF-1 伪 -HIF-2 伪 in OSAHS patients under chronic intermittent hypoxia. Methods: from December 2015 to December 2016, 41 male Han Chinese patients in Xining were selected as the case group, who were diagnosed as OSAHS by polysomnography and polysomnography in sleep monitoring room of Department of Apnea, affiliated Hospital of Qinghai University. The control group selected healthy male who had normal physical examination result in our hospital physical examination center, inquired the medical history in detail, strictly according to the inclusion standard and the exclusion standard and the PSG examination excluded the sleep disease, in age, the gender, There were 32 cases which were matched with the case group in general, such as living altitude and so on. Peripheral venous blood was collected on an empty stomach in the morning. The concentration of HIF-1 伪 -HIF-2 伪 in serum was detected by quantitative enzyme linked immunosorbent assay (Elisa). Results 1. The apnea hypopnea index, oxygen desaturation index and oxygen saturation in the OSAHS group were significantly higher than those in the control group (P 0.001), which were respectively (57.829.970.8) times of apnea hypopnea index, oxygen reduction index and oxygen saturation less than 90% of the total sleep time, which were respectively ([57.829.970.8) times / h vs. [1.5v / 1.0 / 2.3s] / r / h ([59.40.33 / 75.75.7] / h vs. [3.01.55.2)] / (84.037.895.995 / 9) vs. Minimum oxygen saturation, 娓呮櫒姘чケ鍜屽害鍧囨樉钁椾綆浜庡�圭収缁�(P0.001),鍒嗗埆涓，

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