阻塞性睡眠呼吸暂停低通气综合征患者β-胶原特殊序列与总1型胶原氨基端延长肽的变化及其临床意义

发布时间：2018-06-11 18:38

  本文选题：阻塞性睡眠呼吸暂停低通气综合征 + 骨质疏松　； 参考：《山西医科大学》2013年硕士论文

【摘要】：目的：观察阻塞性睡眠呼吸暂停低通气综合征（Obstructive Sleep apnea-hypopneaSyndrome, OSAS)患者以及骨质疏松患者血清中6-胶原特殊序列（6-Crosslaps，旦-cTX)与总1型胶原氨基端延长肽（Total Procollagen Type1Intact N-terminalPropeptide, total P1NP)浓度变化，探讨3-Crosslaps与total P1NP在OSAS引起骨代谢紊乱中的作用及其临床意义。 方法：为排除女性雌激素水平对骨代谢的影响，本研宄选取2012年8月至2013年3月期间与我院就诊的男性作为受试者。选取经我院体检中心检查后的健康、单纯肥胖男性14例作为对照组；同时选取经我院睡眠监测中心经多导睡眠监测(Polysomnography, PSG)确诊为OSAS的男性患者44例，并按睡眠呼吸紊乱指数(Apnea-hypopnea index，AHI)、夜间最低血氧饱和度(minimum blood oxygensaturation，SaChmiJ为依据，分为轻度组16人，中度组14人，重度组14人；选取我院内分泌及骨科诊断为骨质疏松的男性患者14例。所有受试者均记录姓名、年龄、身高、体重、胸围、腰围、糖尿病、肾脏疾病、内分泌疾病、冠心病、高血压等家族史，同时经过7个小时以上时间的多导睡眠监测，，得到呼吸紊乱指数、夜间最低血氧饱和度等相关指标，并于清晨抽取空腹外周静脉血，在我院化验室采用电化学发光法测定0-Crosslaps与total P1NP血清浓度，同时在放射科采用放射线吸收法测定腰椎骨密度（bone mineral density，BMD)。 结果： 1. OSAS轻度组、中度组、重度组、单纯肥胖组受试者的e-Crosslaps血清浓度分别为（0.563mg/ml、0.594mg/ml、0.665mg/ml、0.45mg/ml)，均低于单纯骨质疏松组（0.75mg/ml)，差异有统计学意义（P0.05)，且OSAS轻度、中度、重度组之间差异有统计学意义（P0.05); 2. OSAS轻度组、中度组、重度组、单纯肥胖组受试者的totalP1NP血清浓度分别为（50.03ng/ml、54.11ng/ml、62.97ng/ml、38.17ng/ml)，均低于单纯骨质疏松组（66.05ng/ml)，差异有统计学意义（P0.05)，且OSAS轻度、中度、重度组之间差异有统计学意义（P0.05); 3. OSAS患者的e-Crosslaps、total P1NP血清浓度与AHI呈正相关，相关指数分别为（0.402，0.479，P0.05)，与Sa02mm呈负相关，相关指数分别为（-0.349，-0.303，P0.05)o 4. OSAS的严重程度与AHI、^-Crosslaps total P1NP呈正相关，相关指数分别为(0.942、0.351、0.365，P0.05)，与Sa02mm呈负相关，相关指数为（-0.792，P0.05)o 结论： 1. OSAS患者的-Crosslaps血清浓度较单纯肥胖者升高，且升高水平与AHI、S a02min相关； 2. OSAS患者的total P1NP血清浓度较单纯肥胖者升高，且升高水平与AHI、S a02min相关； 3.旦-Crosslaps与total P1NP血清浓度可作为OSAS患者评估骨代谢的指标o
[Abstract]:Objective: To observe the concentration changes of 6- collagen specific sequence (6-Crosslaps, denier -cTX) in patients with obstructive sleep apnea hypopnea syndrome (Obstructive Sleep apnea-hypopneaSyndrome, OSAS) and the total type 1 collagen amino end lengthening peptide (Total Procollagen Type1Intact N-terminalPropeptide, total). Objective to investigate the role and clinical significance of 3-Crosslaps and total P1NP in OSAS induced bone metabolism disorders.
Methods: to exclude the effect of female estrogen level on bone metabolism, we selected men who visited our hospital from August 2012 to March 2013 as subjects. 14 cases of simple obese men were selected as the control group, and the sleep monitoring center of our hospital was monitored by polysomnography (Poly Somnography, PSG) 44 male patients diagnosed as OSAS, and according to the sleep respiratory disturbance index (Apnea-hypopnea index, AHI), the lowest nocturnal oxygen saturation (minimum blood oxygensaturation, SaChmiJ as the basis, divided into mild group 16 people, moderate group 14, severe group 14 people), selected our hospital Endocrinology and department of orthopedics diagnosis of osteoporosis male 14 patients. All the subjects recorded the family history of name, age, height, weight, chest circumference, waist circumference, diabetes, kidney disease, endocrine disease, coronary heart disease, hypertension and other family history, and after 7 hours of polysomnography, the index of respiratory disorder, the lowest night blood oxygen saturation and other related indexes were obtained, and an empty stomach was taken in the morning. The serum concentration of 0-Crosslaps and total P1NP was measured by electrochemiluminescence (ECL) in the laboratory in our hospital, and the bone mineral density (BMD) was measured by radioimmunoassay in the radiology department.
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