阻塞性睡眠呼吸暂停合并抑郁的相关因素研究及血清IL-18表达的意义

发布时间：2018-06-08 00:19

本文选题：阻塞性睡眠呼吸暂停 + 抑郁　；参考：《山西医科大学》2011年硕士论文

【摘要】：目的:拟通过分析OSA患者一般特征、临床指标与抑郁评分的关系,寻找OSA合并抑郁的相关因素并探讨IL-18在其表达过程中的意义。方法:根据睡眠呼吸监测(PSG)与抑郁评分(SDS评分)结果,将所有观察对象为正常组、单纯OSA组、OSA合并抑郁组、单纯抑郁组。采集性别、年龄、文化程度、吸烟史、饮酒史、病程等一般特征及BMI(身高、体重)、ESS(用Epworth嗜睡量表评定患者嗜睡情况)、合并症(如高血压、糖尿病、心血管疾病)和PSG监测指标(AHI、最低血氧饱和度)并进行分层。整夜多导睡眠监测后晨起抽取患者静脉血分离血清做标本,采用酶联免疫吸附测定法(ELISA)检测IL-18、5-HT的含量。用单因素方差分析(四组比较)、LSD-t检验(组间两两比较)、卡方检验、pearson相关、多重线性回归进行数据处理。结果:(1)OSA患者中抑郁的患病率为49.06%,根据年龄、受教育程度和病程及最低SaO2、BMI、ESS和有无并发症的不同,OSA患者的抑郁患病率差异有显著性(P0.01),而不同性别、是否吸烟和饮酒及不同的AHI对OSA患者抑郁的患病率没有明显的影响(P0.05)。(2)单纯抑郁组IL-18的水平较正常组高(P0.05);所有OSA患者IL-18明显较正常人群高(P0.05),而且OSA合并抑郁的患者较单纯OSA患者进一步增高,差异具有显著性(P0.05),正常组、单纯OSA组、OSA合并抑郁组分别为146.41±56.37,265.85±128.95,387.33±106.10。(3)单纯抑郁组5-HT的水平较正常组高(P0.05);所有OSA患者中5-HT的水平较正常组高,OSA合并抑郁组升高更为明显,差异具有显著性(P0.05)、正常组、单纯OSA组、OSA合并抑郁组分别为43.50±20.74,65.76±51.10,102.96±54.48。(4)多重线性回归显示:并发症、BMI及最低SaO2可以解释OSA患者中血清IL-18的变化情况;BMI、ESS及并发症可以解释OSA合并抑郁患者的SDS评分情况。(5)OSA合并抑郁患者血中IL-18与5-HT的水平呈正相关(r=0.59,P0.02)。结论:1 OSA患者中抑郁的患病率为49.06%,OSA患者合并并发症(高血压、糖尿病、心血管病)、伴有严重的最低氧饱和度及中重度嗜睡和肥胖时抑郁的患病率会增加。2 OSA患者中IL-18的含量受并发症、肥胖及最低SaO_2的影响。3 OSA合并抑郁患者SDS评分受肥胖、嗜睡程度及并发症的影响。4 IL-18可能在OSA合并抑郁的发病机制中起一定的作用。
[Abstract]:Objective: to analyze the relationship between general characteristics, clinical indexes and depression scores of OSA patients. Methods: according to the results of sleep apnea monitoring (PSG) and depression score (SDS), all the subjects were divided into normal group and OSA group with depression. Simple depression group. Sex, age, education, smoking history, drinking history, course of disease, and BMI (height, weight) were measured by Epworth somnolence scale (Epworth somnolence scale), complications (such as hypertension, diabetes, etc.) Cardiovascular disease) and PSG monitoring index AHI, the lowest oxygen saturation) and stratification. Serum samples were collected from patients with polysomnography after overnight polysomnography, and the contents of IL-185-HT were detected by enzyme linked immunosorbent assay (Elisa). Univariate analysis of variance (four groups were compared with LSD-t test, chi-square test Pearson correlation, multiple linear regression) data processing. Results the prevalence of depression in patients with OSA was 49.06, according to age. There were significant differences in the prevalence of depression among the patients with education, course of disease, minimum SAO2 BMIESS and OSA with or without complications (P 0.01). There was no significant effect of smoking and drinking and different AHI on the prevalence of depression in OSA patients. (P0.05N. 2) the level of IL-18 in simple depression group was higher than that in normal group, and IL-18 level in all OSA patients was significantly higher than that in normal group, and OSA patients with depression were significantly higher than those in OSA patients with depression. Compared with simple OSA patients, The level of 5-HT in simple depression group was significantly higher than that in normal group (146.41 卤56.37265.85 卤128.95387.33 卤106.10.3), the level of 5-HT in all OSA patients was higher than that in normal group. The difference was significant (P 0.05). Multiple linear regression analysis showed that BMIESS and complications could explain the changes of serum IL-18 in OSA patients with depression and BMIESS and the complications could explain the SDS score of OSA patients with depression. There was a positive correlation between serum IL-18 and 5-HT levels in patients with depression. Conclusion the prevalence rate of depression in patients with OSA is 49.06. The prevalence of depression in diabetes mellitus, cardiovascular disease, severe oxygen saturation and moderate and severe somnolence and obesity increased the level of IL-18 in the patients with OSA by complications, and the effects of obesity and the lowest SaO-2 on SDS score of patients with depression. 3 the SDS score of patients with depression was obese. The effects of somnolence and complications on IL-18 may play a role in the pathogenesis of OSA with depression.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R766

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