OSAHS患者手术治疗前后血清铁调素水平的动态变化及临床意义

发布时间：2018-05-23 20:54

本文选题：阻塞性睡眠呼吸暂停低通气综合症 + 血清铁调素　；参考：《昆明医科大学》2016年硕士论文

【摘要】：[目的]近年来对OSAHS的发生发展、相关疾病、诊断治疗都有大量的研究,并发现该病与血液中多种因子的改变相关。铁调素的发现仅十余年,对其化学结构、生理功能以及影响因素等有一定的了解,但OSAHS和血清铁调素的相关性,在国内外报道甚少。本课题将研究OSAHS治疗前后铁调素的变化的相关临床研究,以此评估其能否成为对OSAHS预后疗效判定中的生物学指标之一。[方法]本研究随机选取2013年12月-2015年3月昆明医科大学第二附属医院确诊中重度OSAHS患者共计66人(其AHI均大于15),均依据其上气道梗阻情况,相应给予H-UPPP和／或鼻中隔偏曲矫正手术+鼻甲部分切除术治疗。根据术前、术后6个月PSG检测结果将患者分为治疗有效组(53人)和治疗无效组(13人),测量各组术前及术后铁调素水平。将所有数据用SPSS 20.0统计软件进行处理分析。[结果]OSAHS患者治疗有效组与治疗无效组的手术前后体重指数(BMI)差异均无统计学意义(P0.05)。治疗有效组OSAHS术前血清铁调素水平1202.33±460.86Pg/ml,与OSAHS术后6个月730.36±364.46Pg/ml相比,差异有统计学意义(P0.05)。治疗无效组术前血清铁调素水平1326.31±302.67Pg/m1与术后6个月1142.27±243.16Pg/ml相比,差异无统计学意义(P0.05)。无论是术前还是术后OSAHS患者血清铁调素与AHI均呈正相关(r=0.791,P0.05)术前与术后OSAHS患者血清铁调素的水平与睡眠监测中的最低SP02呈显著负相关(r=-0.741,p0.05)。[结论]无论术前或术后OSAHS患者血清铁调素的表达与睡眠呼吸暂停低通气指数呈显著正相关,与多导睡眠监测最低SP02呈显著负相关,说明铁调素水平与OSAHS病情程度相关。术后6个月AHI减小≥50%(治疗有效组)的OSAHS患者血清铁调素水平较术前明显降低,差异有统计学意义,而术后6个月AHI减小50%(治疗无效组)的OSAHS患者血清铁调素水平较术前有所降低,差异无统计下意义。铁调素可以评价OSAHS手术后患者病情恢复情况。血清铁调素可以作为评估OSAHS严重程度及OSAHS手术效果的生物学指标。
[Abstract]:[objective] in recent years, the occurrence and development of OSAHS, related diseases, diagnosis and treatment have been a lot of research, and found that the disease is related to the changes of many factors in the blood. Iron modulin has been discovered only for more than ten years and has a certain understanding of its chemical structure physiological function and influencing factors. However the correlation between OSAHS and serum iron modulin is rarely reported at home and abroad. In this study, we will study the changes of iron modulin before and after OSAHS treatment, and evaluate whether it can be used as a biological index in judging the prognosis of OSAHS. [methods] A total of 66 patients with moderate and severe OSAHS were randomly selected from the second affiliated Hospital of Kunming Medical University from December 2013 to March 2015. Their AHI were all greater than 15, all according to their upper airway obstruction. H-UPPP and / or nasal septum deviation correction surgery was given to the treatment of partial turbinate resection. According to the results of preoperative and postoperative PSG test, the patients were divided into two groups: the effective group (53 patients) and the ineffective group (13 patients). The levels of iron modulin were measured before and after operation. All the data were processed and analyzed by SPSS 20.0 statistical software. [results] there was no significant difference in body mass index (BMI) between effective and ineffective OSAHS patients before and after operation (P 0.05). In the effective group, the serum iron modulin level before OSAHS was 1202.33 卤460.86 PG / ml, which was significantly higher than that at 6 months after OSAHS (730.36 卤364.46Pg/ml). There was no significant difference in serum iron modulin levels (1326.31 卤302.67Pg/m1) before operation and 1142.27 卤243.16Pg/ml (6 months after operation) between the ineffective group and the control group (P 0.05). There was a positive correlation between serum iron modulin and AHI in both preoperative and postoperative OSAHS patients (P 0.05). There was a significant negative correlation between the level of serum iron modulin and the lowest SP02 in sleep monitoring in OSAHS patients before and after operation. [conclusion] the expression of serum iron in patients with OSAHS was positively correlated with sleep apnea hypopnea index and negatively correlated with the lowest SP02 monitored by polysomnography, indicating that the level of iron was correlated with the severity of OSAHS. 6 months after operation, the serum levels of iron modulin in OSAHS patients whose AHI decreased more than 50% (effective group) were significantly lower than those before operation, and the difference was statistically significant. At 6 months after operation, the level of serum iron modulin in OSAHS patients with AHI decreased by 50% (ineffective group) was lower than that before operation, and there was no statistical significance between the two groups. Iron tone can be used to evaluate the recovery of patients after OSAHS operation. Serum iron modulin can be used as a biological index to evaluate the severity of OSAHS and the effect of OSAHS surgery.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R766.9

【相似文献】