T细胞CD69表达率及sCD40L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：2019-01-18 09:31

【摘要】： 目的：检测阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者血T细胞CD69表达率及可溶性CD40配体(sCD40L)水平,探讨T细胞CD69表达率及可溶性CD40配体在OSAHS病理生理过程中的意义。方法：按多导睡眠监测仪检查结果将研究对象分为正常对照组(n=20)、轻度OSAHS组(n=16)、中度OSAHS组(n=19)和重度OSAHS组(n=21)。所有研究对象清晨醒后采外周静脉血当天用流式细胞术检测T细胞CD69表达率,用酶联免疫吸附法(ELISA)检测血浆sCD40L浓度。9例中度及重度OSAHS患者行CPAP呼吸机治疗一个晚上再次抽血检测CD69及sCD40L。结果：(1) OSAHS组的T细胞CD69表达率高于正常对照组(7.99%±3.21% vs 4.36%±1.65%,P=0.000),并且与呼吸暂停低通气指数(AHI)(r=0.643,P=0.000)、夜间缺氧时间T-SaO290%(r=0.608,P=0.000)、体重指数BMI(r=0.564,P=0.000)呈正相关,与夜间最低血氧(r=-0.575,p=0.000)呈负相关；(2)OSAHS组血浆sCD40L浓度高于正常对照组(7.14±1.80ng/ml vs 4.00±1.04ng/ml,P=0.000),与AHI (r=0.640,P=0.000)呈正相关,与夜间最低血氧(r=-0.609,P=0.000)呈负相关；(3) OSAHS组T细胞CD69表达率与sCD40L水平成正相关(r=0.496,P=0.000)；(4)接受一个晚上CPAP治疗的OSAHS组T细胞CD69表达率较治疗前下降(9.75%±2.93%vs8.99%±2.03%),但差异无统计学意义(P=0.108)；血浆sCD40L浓度较治疗前下降(8.15±0.92ng/ml vs 7.93±0.50 ng/ml),但差异无统计学意义(P=0.672)。结论：OSAHS患者T细胞CD69表达率、血浆sCD40L浓度升高,而且随着OSAHS病情的加重,变化更明显；而CPAP治疗OSAHS有可能逆转这种改变,提示T细胞CD69及sCD40L有可能参与了OSAHS的病理生理过程。
[Abstract]:Objective: to detect the expression rate of T cell CD69 and the level of soluble CD40 ligand (sCD40L) in patients with obstructive sleep apnea hypopnea syndrome (obstructive sleep apnea-hypopnea syndrome,OSAHS). To investigate the expression rate of T cell CD69 and the significance of soluble CD40 ligand in the pathophysiological process of OSAHS. Methods: according to the results of polysomnography, the subjects were divided into normal control group (n = 20), mild OSAHS group (n = 16), moderate OSAHS group (n = 19) and severe OSAHS group (n = 21). The expression rate of T cell CD69 was detected by flow cytometry on the same day of collecting peripheral venous blood from all subjects in the morning. (ELISA) was used to detect plasma sCD40L concentration. 9 patients with moderate and severe OSAHS were treated with CPAP ventilator one night to detect CD69 and sCD40L.. Results: (1) the expression rate of T cell CD69 in OSAHS group was higher than that in normal control group (7.99% 卤3.21% vs 4.36% 卤1.65% 卤0.000). The nocturnal anoxic time T-SaO was 290.0% (r = 0.608), body mass index (BMI) was positively correlated with nocturnal minimum blood oxygen (r = 0.575p ~ (0.000), and the body mass index (BMI) was positively correlated with the nocturnal minimum blood oxygen (r = 0.575p ~ (0.000). (2) the concentration of plasma sCD40L in OSAHS group was higher than that in normal control group (7.14 卤1.80ng/ml vs 4.00 卤1.04ng / ml), and was positively correlated with AHI (r 0.640.40), and correlated with nocturnal minimum blood oxygen (r-0.609), the level of plasma sCD40L in OSAHS group was higher than that in normal control group (7.14 卤1.80ng/ml vs 4.00 卤1.04ng / ml). P0. 000) was negatively correlated. (3) there was a positive correlation between the expression rate of CD69 and the level of sCD40L in T cells of OSAHS group (r = 0.496, P > 0.000). (4) the expression rate of T cell CD69 in OSAHS group treated with one night CPAP was lower than that before treatment (9.75% 卤2.93 vs 8.99% 卤2.03%), but there was no significant difference (P0. 108). The concentration of plasma sCD40L decreased (8.15 卤0.92ng/ml vs 7.93 卤0.50 ng/ml), but there was no significant difference (P0. 672). Conclusion: the expression rate of T cell CD69 and the concentration of plasma sCD40L in patients with OSAHS are increased, and the changes are more obvious with the exacerbation of OSAHS, which may be reversed by CPAP treatment of OSAHS, suggesting that CD69 and sCD40L of T cells may be involved in the pathophysiological process of OSAHS.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R766

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