血管生成素样蛋白4与阻塞性睡眠呼吸暂停低通气综合征的相关性研究
发布时间：2018-11-15 12:56
【摘要】： 目的：通过检测阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清血管生成素样蛋白4(Angpt14)水平,研究它与人体参数及脂代谢各指标的关系,探讨Angpt14与OSAHS的关系及其在OSAHS发病机制中的作用。 方法：所有研究对象均来自于2009年4月至2010年1月在山西医科大学第一医院就诊的患者,均行7小时多导睡眠图(PSG)监测系统进行监测。按入院时间先后,选择确诊OSAHS的患者50例为OSAHS组。OSAHS患者根据《中华结核和呼吸杂志》2002年4月发表的“阻塞性睡眠呼吸暂停低通气综合征诊治指南(草案)”确诊,排除由小颌畸形、鼻中隔偏曲等解剖因素所致者,及糖尿病、高血压病、冠心病、脑梗死、动脉粥样硬化、肿瘤、手术应激、慢性肾病、其他慢性缺氧性疾病,伴有心、肾功能衰竭等严重并发症及正在口服降脂药的病例。选择年龄、民族、性别与相应OSAHS患者匹配,PSG监测未达到OSAHS诊断标准的正常人35名为健康对照组。分别采取OSAHS病例组及健康对照组的基线资料及清晨空腹静脉血,酶联免疫法测定OSAHS病例组和健康对照组的血清Angpt14水平,生化法测定血脂。最后进行相关统计分析。 结果：1.OSAHS组与健康对照组年龄、性别无显著性差异(P＞0.05)。与健康对照组相比,OSAHS组颈围、腹围、BMI、腰髋比明显增大(P0.01), TC、TG、LDL-C、Angpt14明显升高(P0.01), HDL-C明显降低(P0.01)。OSAHS组较健康对照组AHI、最低SO2＜90%时间明显增加(p＜0.05),最低血氧饱和度及平均血氧饱和度较正常对照组显著降低(p0.05)。 2.TG、LDL-C与AHI呈显著正相关,HDL-C与AHI呈负相关。控制BMI及年龄后,TG仍与AHI呈显著正相关。 3.BMI、颈围、腹围、腰围、臀围、腰髋比均与AHI呈显著正相关。控制BMI后,颈围、腹围、腰围、腰髋比仍与AHI呈显著正相关。 4. OSAHS组中血清Angpt14浓度与颈围、腹围、腰围呈显著正相关(P＜0.05),而与BMI、腰髋比无显著相关性(P＞0.05)。OSAHS组中血清Angpt14浓度与AHI、最低SO2＜90%时间呈正相关(p＜0.05),与平均SO2、最低SO2呈显著负相关(p＜0.05)。OSAHS组中血清Angpt14浓度与HDL-C呈显著负相关(p＜0.05),与TG呈显著正相关(p＜0.05),而与TC、LDL-C无显著相关性。 结论：1. OSAHS与肥胖密切相关,颈围、腰围、腹围是OSAHS病情严重程度的独立预测指标。OSAHS患者存在脂代谢紊乱,并且TG独立于肥胖和年龄之外与AHI相关,即高甘油三酯血症越严重,OSAHS病情越严重。 2. OSAHS患者血清Angpt14明显升高,且其浓度能反映OSAHS病情的严重程度及低氧血症的严重程度。 3. Angpt14可能参与OSAHS患者脂代谢紊乱的形成。 4. OSAHS患者血清Angpt14水平与颈围、腰围、腹围等正相关,可能是Angpt14在不同部位脂肪组织中特异分布的结果。
[Abstract]:Objective: to study the relationship between serum angiopoietin-like protein 4 (Angpt14) and human parameters and lipid metabolism in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). To explore the relationship between Angpt14 and OSAHS and its role in the pathogenesis of OSAHS. Methods: all patients from April 2009 to January 2010 in the first Hospital of Shanxi Medical University were monitored by a 7-hour polysomnography (PSG) monitoring system. According to the time of admission, 50 patients with OSAHS were selected as OSAHS group. The diagnosis of OSAHS was confirmed according to the "guidelines for the diagnosis and treatment of obstructive sleep apnea hypopnea syndrome (OSAS)" published in April 2002 by the Chinese Journal of Tuberculosis and Respiratory. Excluded from anatomical factors such as maxillary malformation, nasal septum deviation, and diabetes, hypertension, coronary heart disease, cerebral infarction, atherosclerosis, tumor, surgical stress, chronic nephropathy, other chronic hypoxic diseases, accompanied by heart disease, Severe complications such as renal failure and ongoing oral lipid-lowering drugs. Age, nationality and sex were matched with the corresponding OSAHS patients. 35 normal subjects who did not meet the diagnostic criteria of OSAHS were selected as the healthy control group. The baseline data of OSAHS and healthy control group and the fasting venous blood in the morning were used respectively. The serum Angpt14 levels were measured by enzyme-linked immunosorbent assay (Elisa) and the serum lipids were measured by biochemical method. Finally, the related statistical analysis is carried out. Results: there was no significant difference in age and sex between 1.OSAHS group and healthy control group (P > 0. 05). Compared with the healthy control group, the neck circumference, abdominal circumference, BMI, waist hip ratio of OSAHS group increased significantly (P0.01), TC,TG,LDL-C,Angpt14 significantly increased (P0.01), and HDL-C decreased significantly (P0.01). OSAHS group than the healthy control group AHI,). The minimum SO2 < 90% time was significantly increased (p < 0. 05), and the minimum oxygen saturation and mean oxygen saturation were significantly lower than those in the normal control group (p < 0. 05). 2. There was a significant positive correlation between LDL-C and AHI, and a negative correlation between HDL-C and AHI. After the control of BMI and age, there was still a significant positive correlation between TG and AHI. 3. BMI, neck circumference, abdominal circumference, waist circumference, hip circumference and waist hip ratio were positively correlated with AHI. After BMI control, neck circumference, abdominal circumference and waist hip ratio were still positively correlated with AHI. 4. Serum Angpt14 concentration was positively correlated with neck circumference, abdominal circumference and waist circumference in OSAHS group (P < 0. 05), but had no significant correlation with BMI, waist hip ratio (P > 0. 05). OSAHS). The minimum SO2 < 90% time was positively correlated (p < 0. 05), and negatively correlated with the mean SO2, minimum SO2 (p < 0. 05). The serum Angpt14 concentration was negatively correlated with HDL-C in the). OSAHS group (p < 0. 05). There was a significant positive correlation with TG (p < 0. 05), but no significant correlation with TC,LDL-C. Conclusion 1. OSAHS is closely related to obesity. Neck circumference, waist circumference and abdominal circumference are independent predictors of the severity of OSAHS. There is lipid metabolism disorder in OSAHS patients, and TG is associated with AHI independently of obesity and age, that is, hypertriglyceridemia is more serious. The more serious OSAHS is, the more serious it is. 2. The serum Angpt14 level in OSAHS patients was significantly increased, and its concentration could reflect the severity of OSAHS and hypoxemia. 3. Angpt14 may be involved in the formation of lipid metabolism disorder in patients with OSAHS. 4. The serum Angpt14 level in OSAHS patients was positively correlated with neck circumference, waist circumference and abdominal circumference, which may be the result of specific distribution of Angpt14 in adipose tissue of different parts.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R766
本文编号：2333368
[Abstract]:Objective: to study the relationship between serum angiopoietin-like protein 4 (Angpt14) and human parameters and lipid metabolism in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). To explore the relationship between Angpt14 and OSAHS and its role in the pathogenesis of OSAHS. Methods: all patients from April 2009 to January 2010 in the first Hospital of Shanxi Medical University were monitored by a 7-hour polysomnography (PSG) monitoring system. According to the time of admission, 50 patients with OSAHS were selected as OSAHS group. The diagnosis of OSAHS was confirmed according to the "guidelines for the diagnosis and treatment of obstructive sleep apnea hypopnea syndrome (OSAS)" published in April 2002 by the Chinese Journal of Tuberculosis and Respiratory. Excluded from anatomical factors such as maxillary malformation, nasal septum deviation, and diabetes, hypertension, coronary heart disease, cerebral infarction, atherosclerosis, tumor, surgical stress, chronic nephropathy, other chronic hypoxic diseases, accompanied by heart disease, Severe complications such as renal failure and ongoing oral lipid-lowering drugs. Age, nationality and sex were matched with the corresponding OSAHS patients. 35 normal subjects who did not meet the diagnostic criteria of OSAHS were selected as the healthy control group. The baseline data of OSAHS and healthy control group and the fasting venous blood in the morning were used respectively. The serum Angpt14 levels were measured by enzyme-linked immunosorbent assay (Elisa) and the serum lipids were measured by biochemical method. Finally, the related statistical analysis is carried out. Results: there was no significant difference in age and sex between 1.OSAHS group and healthy control group (P > 0. 05). Compared with the healthy control group, the neck circumference, abdominal circumference, BMI, waist hip ratio of OSAHS group increased significantly (P0.01), TC,TG,LDL-C,Angpt14 significantly increased (P0.01), and HDL-C decreased significantly (P0.01). OSAHS group than the healthy control group AHI,). The minimum SO2 < 90% time was significantly increased (p < 0. 05), and the minimum oxygen saturation and mean oxygen saturation were significantly lower than those in the normal control group (p < 0. 05). 2. There was a significant positive correlation between LDL-C and AHI, and a negative correlation between HDL-C and AHI. After the control of BMI and age, there was still a significant positive correlation between TG and AHI. 3. BMI, neck circumference, abdominal circumference, waist circumference, hip circumference and waist hip ratio were positively correlated with AHI. After BMI control, neck circumference, abdominal circumference and waist hip ratio were still positively correlated with AHI. 4. Serum Angpt14 concentration was positively correlated with neck circumference, abdominal circumference and waist circumference in OSAHS group (P < 0. 05), but had no significant correlation with BMI, waist hip ratio (P > 0. 05). OSAHS). The minimum SO2 < 90% time was positively correlated (p < 0. 05), and negatively correlated with the mean SO2, minimum SO2 (p < 0. 05). The serum Angpt14 concentration was negatively correlated with HDL-C in the). OSAHS group (p < 0. 05). There was a significant positive correlation with TG (p < 0. 05), but no significant correlation with TC,LDL-C. Conclusion 1. OSAHS is closely related to obesity. Neck circumference, waist circumference and abdominal circumference are independent predictors of the severity of OSAHS. There is lipid metabolism disorder in OSAHS patients, and TG is associated with AHI independently of obesity and age, that is, hypertriglyceridemia is more serious. The more serious OSAHS is, the more serious it is. 2. The serum Angpt14 level in OSAHS patients was significantly increased, and its concentration could reflect the severity of OSAHS and hypoxemia. 3. Angpt14 may be involved in the formation of lipid metabolism disorder in patients with OSAHS. 4. The serum Angpt14 level in OSAHS patients was positively correlated with neck circumference, waist circumference and abdominal circumference, which may be the result of specific distribution of Angpt14 in adipose tissue of different parts.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R766
【参考文献】
相关期刊论文 前1条
1 朱洪新,李锦军,覃文新,杨艳华,何祥火,万大方,顾健人;新基因ANGPTL4的克隆及其在血管新生中的功能研究[J];中华医学杂志;2002年02期
，本文编号：2333368
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