阻塞性睡眠呼吸暂停低通气综合征患者血清癌胚抗原和T淋巴细胞亚群水平的研究

发布时间：2018-05-26 08:29

本文选题：阻塞性睡眠呼吸暂停低通气综合征 + T淋巴细胞亚群　；参考：《福建中医药大学》2017年硕士论文

【摘要】：目的:分析成人阻塞性睡眠呼吸暂停低通气综合征(Obstructive sleep apnea hypopnea syndrome,OSAHS)患者外周血清癌胚抗原(Cancer embryo antigen,CEA)和T淋巴细胞亚群(T lymphocyte subsets,T-LS)水平的变化,了解该类患者与健康人群CEA及T-LS水平的差异性;探讨OSAHS患者免疫功能的变化及OSAHS与癌症的相关性,检验OSAHS患者癌胚抗原水平变化是否与T-LS水平变化有关。方法:选择2015年3月至2017年1月期间莆田学院附属医院呼吸内科门诊及住院确诊为OSAHS的患者85例为OSAHS组,按病情的严重程度将患者分为轻度组、中度组、重度组,按病程长短将患者分为长病程组(5年)和短病程组(5年),同期选择门诊健康体检者32例作为对照组。检测所有研究对象外周血清CEA和T-LS水平,比较各组之间外周血清CEA和T-LS水平的差异。同时记录所有研究对象多导图睡眠监测中呼吸暂停低通气指数(apnea hypopnea index,AHI)和最低血氧饱和度(lowest Oxygen saturation,LSa02)监测结果,分析 OSAHS 患者外周血清 CEA、T-LS、AHI 及 LSaO2之间的关系。结果:(1)与对照组比较,OSAHS组患者血清CD3+CD4+T细胞百分率和CD4+/CD8+比值明显下降(P0.05),CEA水平升高(P0.05),而CD3+和CD3+CD8+T细胞百分率均无显著差异(P0.05)。(2)不同OSAHS病情分组比较:各组之间血清CD3+和CD3+CD8+T细胞百分率均无显著差异(P0.05)。轻度组和中度组患者血清CD3+CD4+T细胞百分率均明显低于对照组(P0.05),重度组患者血清CD3+CD4+T细胞百分率明显低于对照组、轻度组和中度组(P0.05)。轻度组和中度组患者之间的血清CD3+CD4+T细胞百分率无显著差异(P0.05)。重度组患者CD4+/CD8+比值明显低于对照组、轻度组和中度组,中度组CD4+/CD8+比值明显低于对照组,差异均具有显著意义(P0.05)。而对照组和轻度组之间的CD4+/CD8+比值无明显差异(P0.05)。重度组患者血清CEA水平明显高于对照组、轻度组和中度组,差异均具有显著意义(P0.05)。而对照组、轻度组和中度组三组之间的血清CEA均无明显差异(P0.05)。(3)不同OSAHS病程分组比较:长病程组患者血清CD3+T淋巴细胞百分率低于对照组和短病程组(P0.05),CEA水平明显高于对照组和短病程组(P0.05)。对照组和短病程组之间CD3+T细胞百分率和CEA水平均无显著差异(P0.05)。三组之间的血清CD3+CD8+T淋巴细胞百分率无显著差异(P0.05)。长病程组CD3+CD4+T细胞百分率明显低于对照组和短病程组(P0.05),短病程组CD3+CD4+T细胞百分率明显低于对照组(P0.05)。对照组患者的CD4+/CD8+比值高于短病程组和长病程组(P0.05)。短病程组和长病程组之间的CD4+/CD8+比值无显著差异(P0.05)。(4)对OSAHS组AHI、LSa02、T-LS及CEA进行相关性分析,结果显示:OSAHS组患者CD3+T细胞水平与AHI、LSaO2和CEA均不存在相关性(P0.05)。OSAHS组患者CD3+CD4+T细胞水平与AHI、LSaO2和CEA均存在显著相关性(P0.01),其中CD3+CD4+T细胞水平与AHI和CEA水平呈负相关,与LSaO2呈正相关。OSAHS组患者CD3+CD8+T细胞水平与AHI、LSa02均存在相关性(P0.05),其中CD3+CD8+T细胞水平与AHI呈正相关,与LSaO2呈负相关。CD3+CD8+T细胞水平与CEA水平不存在相关性(P0.05)。OSAHS组患者外周血清CD4+/CD8+比值与AHI、LSaO2和CEA均存在显著相关性(P0.01),其中CD4+/CD8+比值与AHI和CEA水平呈负相关,与LSa02呈正相关。OSAHS组患者外周血清CEA水平与AHI、LSa02均存在显著相关性(P0.01),其中CEA水平与AHI呈正相关,与LSaO2呈负相关。结论:1、OSAHS患者体内存在T-LS水平改变,且与病情严重程度及病程长短相关,提示OSAHS患者可能存在不同程度的免疫功能下降。2、OSAHS患者体内存在血清CEA水平升高,主要集中在长病程和重度的OSAHS患者。3、OSAHS患者体内血清CEA和T-LS水平与AHI、LSa02均存在线性相关,说明AHI和LSa02可能是影响OSAHS患者免疫功能和CEA水平的因素之一。4、OSAHS患者体内CEA水平与CD3+CD4+T细胞水平、CD4+/CD8+比值均存在线性相关,说明OSAHS患者体内血清CEA水平升高可能与其免疫功能下降有关。
[Abstract]:Objective: to analyze the changes of peripheral serum carcinoembryonic antigen (Cancer embryo antigen, CEA) and T lymphocyte subsets in patients with adult obstructive sleep apnea hypopnea syndrome (Obstructive sleep apnea hypopnea syndrome, OSAHS). To investigate the changes of immune function in OSAHS patients and the correlation between OSAHS and cancer, and to examine whether the change of the level of carcinoembryonic antigen in OSAHS patients is related to the level of T-LS. Methods: 85 patients with OSAHS in the respiratory department of Affiliated Hospital of Putian College from March 2015 to January 2017 were selected as OSAHS group, according to the severe course of the disease. The patients were divided into mild group, moderate group and severe group. The patients were divided into long course group (5 years) and short course group (5 years) according to the duration of the disease, and 32 cases in the same period were selected as the control group. The serum CEA and T-LS levels of all the subjects were measured, and the difference of serum CEA and T-LS levels between each group was compared. The monitoring results of the apnea hypopnea index (AHI) and the lowest oxygen saturation (lowest Oxygen saturation, LSa02) in the sleep monitoring of subjects were studied. The relationship between CEA, T-LS, AHI, and LSa02 in the peripheral serum of patients with OSAHS was analyzed. (1) compared with the control group, the percentage of serum cells in the patients was compared with the control group. The ratio of rate to CD4+/CD8+ decreased significantly (P0.05) and the level of CEA increased (P0.05), but there was no significant difference in the percentage of CD3+ and CD3+CD8+T cells (P0.05). (2) the percentages of CD3+ and CD3+CD8+T cells in serum were not significantly different among the different OSAHS cases (P0.05). The percentage of the serum CD3+CD4+T cells in the mild and moderate groups were both obvious. The percentage of serum CD3+CD4+T cells in the severe group was significantly lower than that of the control group (P0.05). The percentage of serum CD3+CD4+T cells between the mild group and the moderate group was not significantly different (P0.05). The CD4+/CD8+ ratio in the severe group was significantly lower than that in the control group, the mild group and the moderate group, and the moderate group CD4+/CD8. The ratio of + to the control group was significantly lower than that of the control group (P0.05), but the CD4+/CD8+ ratio between the control group and the mild group was not significantly different (P0.05). The serum CEA level in the severe group was significantly higher than that in the control group. The difference between the mild group and the moderate group was significant (P0.05). The control group, the serum between the mild group and the moderate group, was between the three groups. There was no significant difference in CEA (P0.05). (3) the comparison of different OSAHS course groups: the percentage of serum CD3+T lymphocytes in the long course group was lower than the control group and the short course group (P0.05), and the CEA level was significantly higher than the control group and the short course group (P0.05). There was no significant difference between the percentage of CD3+T cells and the level of CEA between the control group and the short course group (P0.05). (P0.05). The percentage of CD3+CD8+T lymphocyte in serum was no significant difference (P0.05). The percentage of CD3+CD4+T cells in the long course group was significantly lower than that of the control group and the short course group (P0.05). The percentage of CD3+CD4+T cells in the short course group was significantly lower than that of the control group (P0.05). The CD4+/CD8+ ratio in the control group was higher than the short course group and the long course group (P0.05). There was no significant difference in the CD4+/CD8+ ratio between the long course group and the long course group (P0.05). (4) the correlation analysis of AHI, LSa02, T-LS and CEA in group OSAHS showed that there was no correlation between CD3+T cell level in OSAHS group and AHI, LSaO2 and CEA. The level of CD3+CD4+T cells was negatively correlated with the level of AHI and CEA, and there was a positive correlation between the level of CD3+CD8+T cell and LSa02 in the.OSAHS group with LSaO2 (P0.05), and the CD3+CD8+T cell level was positively correlated with AHI, and the negative correlation with LSaO2 was not associated with the level of the peripheral blood of the patients. There was a significant correlation between the ratio of CD4+/CD8+ and AHI, LSaO2 and CEA (P0.01), and the CD4+/CD8+ ratio was negatively correlated with the level of AHI and CEA, and there was a positive correlation between the CEA level of the peripheral serum and AHI, which was positively correlated with LSa02 in the.OSAHS group of the.OSAHS group. The change of memory at T-LS level is related to the severity of the disease and the duration of the disease, suggesting that OSAHS patients may have different levels of immune function.2, and the level of serum CEA in OSAHS patients is elevated, mainly in the long course and severe OSAHS patients.3, and the serum CEA and T-LS levels and AHI in the serum of OSAHS patients and the linearity of the LSa02 are linear. It is suggested that AHI and LSa02 may be one of the factors affecting the immune function and CEA level of OSAHS patients.4. The level of CEA in OSAHS patients is linearly related to the level of CD3+CD4+T cells and the ratio of CD4+/CD8+, indicating that the increase of CEA level in the serum of OSAHS patients may be related to the decrease of immune function.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R766

【相似文献】