阻塞性睡眠呼吸暂停综合征患者血清脂肪细胞脂肪酸结合蛋白水平的检测及分析

发布时间：2018-03-05 04:31

  本文选题：阻塞性睡眠呼吸暂停综合征　切入点：脂肪细胞脂肪酸结合蛋白　出处：《山东大学》2010年硕士论文　论文类型：学位论文

【摘要】： 背景：脂肪细胞脂肪酸结合蛋白(adipocyte-fatty acid binding protein, A-FABP)是新近发现的一种细胞内的重要的溶质蛋白,属于脂肪酸结合蛋白大家族,最早在脂肪组织中被发现,现发现其广泛存在于各种正常的组织细胞中,并可以由脂肪细胞分泌到血液,在血液循环中稳定存在。A-FABP可以促进脂肪酸的代谢和转运,与糖脂代谢及炎症反应有密切的关系。近年来的多种临床及动物实验均表明A-FABP与阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome, OSAS)有明显的相关性。我们主要通过对患者血清A-FABP的检测,揭示A-FABP在OSAS患者与正常人之间水平的差异,探讨A-FABP与OSAS之间的关系。 方法：依据中华医学会耳鼻咽喉科学分会、中华耳鼻咽喉科学杂志编委会2002年杭州会议关于阻塞性睡眠呼吸暂停综合征的诊断标准,选择2009年1月至2010年2月在山东大学第二医院诊断为阻塞性睡眠呼吸暂停综合征的门诊或住院的患者25例为实验组,年龄32～60岁(43.12±9.84岁),均为男性,均经多导睡眠监测(polysomnography, PSG)证实。另选无睡眠打鼾及呼吸暂停的15例作为正常对照组,年龄22～66岁(43.87±12.83岁),亦均为男性。两组均无高血压及糖尿病病史,无高脂血症及心血管疾病,年龄差别无显著性。测量并记录所有受试者的身高、体重,计算体质量指数(body mass index, BMI)。采用酶联免疫分析法(enzyme-linked immunosorbent assays, ELISA)检测其血清中A-FABP的浓度。 结果：OSAS患者血清A-FABP的浓度为35.68±10.11 ng／m1,高于正常对照组18.61±7.26 ng／ml,二者之间的差异有显著性(t=5.75,P0.05)。将A-FABP值与睡眠呼吸暂停低通气指数(apnea-hypopnea index, AHI)、最低血氧饱和度、最长呼吸暂停时间、呼吸暂停及低通气总时间、呼吸暂停总次数、氧减指数做相关分析,发现A-FABP与AHI、呼吸暂停及低通气总时间、呼吸暂停总次数、氧减指数呈正相关(P0.05),与最低血氧饱和度呈负相关(P0.05),与最长呼吸暂停时间无明显相关性(P0.05)。将病例组根据AHI分为轻中重三组,轻度(5≤AHI20, A-FABP 25.7±94.90 ng/ml),中度(20≤AHI40, A-FABP 34.55±5.23 ng/ml),重度(AHI≥40, A-FABP 41.44±9.92 ng/ml),发现A-FABP随着OSAS程度的加重而增加。 结论：脂肪细胞脂肪酸结合蛋白在阻塞性睡眠呼吸暂停综合征患者血清中的水平较正常对照组偏高,且与阻塞性睡眠呼吸暂停综合征的严重程度有着明显的相关性。
[Abstract]:Background: adipocyte-fatty acid binding protein (A-FABP-) is a recently discovered solute protein in cells, which belongs to the large family of fatty acid binding proteins and was first found in adipose tissue. It has been found that it exists widely in various normal tissue cells and can be secreted into the blood by adipocytes. The stable presence of .A-FABP in blood circulation can promote the metabolism and transport of fatty acids. In recent years, a variety of clinical and animal experiments have shown that A-FABP has a significant correlation with obstructive sleep apnea syndrome (OSASs). To explore the relationship between A-FABP and OSAS in patients with OSAS and normal subjects. Methods: according to the diagnostic criteria of obstructive sleep apnea syndrome (OSAS), the editorial Committee of the Chinese Journal of Otolaryngology and Otolaryngology of the Chinese Medical Association and the editorial Committee of the Chinese Journal of Otolaryngology, 2002. From January 2009 to February 2010, 25 patients diagnosed as obstructive sleep apnea syndrome (OSAS) in the second Hospital of Shandong University were selected as experimental group, aged 32 to 60 years old, 43.12 卤9.84 years old, all of them were male. All patients were confirmed by polysomnography (PSG). 15 patients without sleep snoring and apnea were selected as normal control group, aged 226.66 years old, 43.87 卤12.83 years old, all of them were male. Both groups had no history of hypertension and diabetes, no hyperlipidemia and cardiovascular disease. Age difference was not significant. The height and weight of all the subjects were measured and recorded. The body mass index (BMI) was calculated. The serum A-FABP concentration was detected by enzyme-linked immunosorbent assays (ELISAs). Results the concentration of A-FABP in the patients with OSAS was 35.68 卤10.11 ng / ml, which was higher than that in the control group (18.61 卤7.26 ng / ml). There was a significant difference between A-FABP and apnea-hypopnea index (AHIO _ 2), the longest apnea duration, and the apnea-hypopnea index. The total time of apnea and hypopnea, the total number of apnea, oxygen reduction index, A-FABP and AHI, the total time of apnea and hypopnea, the total number of apnea, the total number of apnea, There was a positive correlation between oxygen reduction index (P 0.05), negative correlation with minimum oxygen saturation (P 0.05) and no significant correlation with the longest apnea time (P 0.05). The case group was divided into three groups according to AHI. Mild 5 鈮，

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