OSAHS患者血清中MIF及sCD40L的检测及意义

发布时间：2018-03-10 02:19

本文选题：睡眠呼吸暂停低通气综合征　切入点：巨细胞移动抑制因子　出处：《南华大学》2010年硕士论文　论文类型：学位论文

【摘要】： 目的对重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者体内术前术后巨噬细胞移动抑制因子(MIF)与可溶性CD40配体(sCD40L)浓度水平进行检测,探讨MIF及sCD40L与患者疾病的相关性,同时探讨MIF与sCD40L在患者体内的相关性,更进一步了解患者体内氧化应激与炎症反应及相关炎症因子之间的关系。为OSAHS的诊断和治疗提供新的依据。方法将已经通过PSG监测诊断为重度OSAHS的男性患者29例设为实验组,选取29例健康男性作为对照组。应用酶联免疫吸附法(ELISA)对各组血清巨噬细胞移动抑制因子(MIF)及sCD40L水平进行检测,对OSAHS组进行改良腭咽成形术,解除其呼吸道阻塞,于术后6个月对OSAHS患者复查PSG。同时复查血清巨噬细胞移动抑制因子(MIF)及sCD40L。将所得结果进行统计学分析,观察手术前后患者血清巨细胞移动抑制因子(MIF)及sCD40L水平的变化,了解实验组与对照组血清巨细胞移动抑制因子(MIF)及sCD40L水平差异,同时观察PSG各项指标的变化。结果 1.手术前后PSG各项指标变化 OSAHS患者术前术后PSG监测主要指标对比,各测值均用X±s表示,各组的数据应用配对t检验进行统计学分析,发现术后血氧饱和度上升(术前65.58±11.35,术后84.55±4.33)(P0.000),呼吸紊乱指数(AHI)下降(术前59.74±17.74,术后20.97±9.94)(P0.000),有显著差异性。 2.手术前后患者MIF血清浓度变化各组MIF(术前术后对照组)水平比较,结果用X±s表示,术前术后组比较应用配对t检验,术前、术后与对照组比较应用两样本t检验。OSAHS患者术后6个月血清MIF值有显著下降(术前4.03±0.78ng/ml,术后2.89±0.75ng/ml)(P0.000),术前组与对照组(术前4.03±0.78ng/ml,对照组2.33±0.56ng/ ml)(P0.000),术后组与对照组(术后2.89±0.75ng/mll,对照组2.33±0.56ng/ ml)(P=0.003)。术前、术后MIF浓度与对照组比较差异均有显著性,术后较术前显著降低。 3.手术前后患者血清sCD40L水平变化各组sCD40L (术前术后对照组)水平比较,结果用X±s表示,术前、术后组比较应用配对t检验,术前、术后与对照组比较应用两样本t检验。OSAHS患者术后6个月血清sCD40L值有显著下降(术前6.68±1.63ng/ml,术后4.50±1.10 ng/ml)(P0.000),术前组与对照组(术前6.68±1.63ng/ml,对照组3.11±0.69ng/ml)(P0.000),术后组与对照组(术后4.50±1.10 ng/ml,对照组3.11±0.69ng/ml)(P0.05)。术前、术后sCD40L浓度与对照组比较差异均有显著性,术后较术前显著降低。结论 1. MIF和sCD40L在重度OSAHS患者血清中浓度升高。 2.术后6个月MIF及sCD40L均有显著下降。 3.OSAHS患者血清MIF及sCD40L呈正相关关系。 4. MIF和sCD40L可以作为OSAHS患者手术疗效评判的重要指标。
[Abstract]:objective
For severe obstructive sleep apnea hypopnea syndrome (OSAHS) patients with macrophage migration inhibitory factor before and after operation (MIF) and soluble CD40 ligand (sCD40L) levels were detected, and to investigate the correlation between MIF and sCD40L patients, and to investigate the correlation between MIF and sCD40L in the patient's body, to further understand the relationship between between oxidative stress and inflammatory responses in patients and the related inflammatory factors. To provide a new basis for the diagnosis and treatment of OSAHS.
Method
Will have been monitored by PSG for diagnosis of severe OSAHS and 29 patients for the experimental group, 29 healthy men were selected as control group. Enzyme linked immunosorbent assay (ELISA) on serum macrophage migration inhibitory factor (MIF) were detected and the level of sCD40L, OSAHS group received uvulopalatopharyngoplasty, lift the respiratory tract obstruction, 6 months after the operation of OSAHS patients PSG. and review of serum macrophage migration inhibitory factor (MIF) and sCD40L. statistical analysis of the results was performed before and after surgery, observation of serum in patients with giant cell migration inhibitory factor (MIF) and sCD40L levels in serum, understand the mobile giant cell in experimental group and control (inhibitory factor MIF) difference and the level of sCD40L, PSG and changes of each index of observation.
Result
1. changes of every index of PSG before and after operation
Comparison of main indexes of PSG monitoring OSAHS patients before and after surgery, the measured values are expressed by X + s, data application group paired t test was used for statistical analysis, found that postoperative oxygen saturation increased (65.58 preoperative and postoperative 84.55 + 11.35, + 4.33) (P0.000), respiratory disturbance index (AHI) decreased (preoperative postoperative 59.74 + 17.74, 20.97 + 9.94) (P0.000), there are significant differences.
2. changes of serum concentration of MIF in patients before and after operation
Group MIF (preoperative? Postoperative? Control group) level, the results were expressed as X + s, before and after surgery were compared using the paired t test, preoperative, postoperative compared with the control group using two sample t test with.OSAHS 6 months after surgery, serum MIF value decreased significantly (4.03 before operation after + 0.78ng/ml, 2.89 + 0.75ng/ml) (P0.000), preoperative group and control group (preoperative 4.03 + 0.78ng/ml, 2.33 + 0.56ng/ control group ml) (P0.000), the postoperative group and the control group (after 2.89 + 0.75ng/mll, 2.33 + 0.56ng/ control group ml) (P=0.003). Before the operation. The postoperative MIF concentration compared with the control group there were significant differences, after operation decreased significantly.
3. changes of serum sCD40L level in patients before and after operation
Group sCD40L (preoperative? Postoperative? Control group) level, the results of X + s, preoperative, postoperative were compared using the paired t test, preoperative, postoperative compared with the control group using two sample t test.OSAHS patients after 6 months of serum sCD40L values were significantly decreased (before operation 6.68 + 1.63ng/ml, 4.50 + 1.10) after ng/ml (P0.000), preoperative group and control group (preoperative control group 6.68 + 1.63ng/ml, 3.11 + 0.69ng/ml) (P0.000), the postoperative group and the control group (after 4.50 + 1.10 ng/ml, control group 3.11 + 0.69ng/ml) (P0.05) before operation. After the operation, the concentration of sCD40L compared with the control group there were significant differences, after operation decreased significantly.
conclusion
The concentrations of 1. MIF and sCD40L in the sera of severe OSAHS patients were increased.
There was a significant decrease in MIF and sCD40L at 6 months after 2..
There is a positive correlation between serum MIF and sCD40L in patients with 3.OSAHS.
4. MIF and sCD40L can be used as an important indicator of the evaluation of the surgical efficacy of OSAHS patients.

【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R766

【参考文献】