OSAHS患者血清TNF-α、Hepcidin水平的检测及相关性研究

发布时间：2019-02-18 21:54

【摘要】：目的：通过定量测定阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome, OSAHS)患者血清中肿瘤坏死因子-α (TNF-α)、铁调素(hep)含量,探讨两者在OSAHS患者中的表达,阐明它们在OSAHS发病过程中的作用。方法：本研究随机选取了2012年3月-2014年3月昆明医学院第二附属医院及云南省第一人民医院确诊为OSAHS患者共计95例(其中轻度24例,中度27例,重度44例),无打鼾的健康人30例作为正常对照组,测定各组血清TNF-α、铁调素的水平。并同时检测各组OSAHS患者睡眠暂停低通气指数(AHI)、最低血氧饱和度(Sp02)两项呼吸睡眠检测指标。将所有数据用SPSS13.5统计软件进行处理分析。结果： 1、OSAHS各组与正常对照组在年龄、体重、体重指数(Body mass index,BMI)比较,差异无统计学意义(P0.05)。 2、TNF-α在OSAHS患者血清中轻度组含量为17.52±2.20pg/ml、中度组为25.05±3.89pg/ml、重度组为43.29±12.95pg/ml,均高于正常对照组11.03±4.22pg/ml,差异均有统计学意义(p0.01),且OSAHS病情程度越严重,TNF-α含量越高。 3、铁调素在OSAHS患者血清中轻度组含量为585.51±111.99pg/ml、中度组为949.24±168.45pg/ml、重度组为1890.95±495.54pg/ml的水平均高于正常对照组375.70±91.47pg/ml,差异均有统计学意义(p0.01),且OSAHS病情程度越严重,铁调素含量越高。 4、OSAHS组血清TNF-α、铁调素呈显著正相关。(r=0.728,p0.01) 5、OSAHS组血清TNF-α、铁调素的水平与睡眠呼吸暂停低通气指数(AHI)呈显著正相关。(r=0.723,r=0.862,p0.01) 6、OSAHS组血清TNF-α、铁调素的水平与睡眠监测中的最低SPO2呈显著负相关。(r=-0.641,r=-0.647,p0.01 结论： 1、OSAHS组中血清TNF-a、铁调素表达水平较正常对照组血清中显著增高,显示血清TNF-α、铁调素的异常表达与OSAHS患者的病情有关。 2、血清TNF-α、铁调素与OSAHS各组之间比较显示存在差异,显示OSAHS病情越严重,两者的表达水平越高。 3、OSAHS组血清TNF-a、铁调素的表达与睡眠呼吸暂停低通气指数呈显著正相关,与睡眠监测最低SpO2呈显著负相关,说明两者与OSAHS病情程度相关。 4、血清TNF-α、铁调素可以作为OSAHS严重程度的生物学指标。
[Abstract]:Objective: to investigate the expression of tumor necrosis factor- 伪 (TNF- 伪) and iron modulin (hep) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) by quantitative determination of serum tumor necrosis factor- 伪 (TNF- 伪) and iron modulin (hep) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). To elucidate their role in the pathogenesis of OSAHS. Methods: from March 2012 to March 2014, 95 patients with OSAHS were randomly selected from the second affiliated Hospital of Kunming Medical College and the first people's Hospital of Yunnan Province (including 24 mild cases, 27 moderate cases, 44 severe cases). The serum levels of TNF- 伪 and iron modulin were measured in 30 healthy subjects without snoring as normal control group. Sleep apnea hypopnea index (AHI),) minimum oxygen saturation (Sp02) was measured in all OSAHS patients. All the data are processed and analyzed by SPSS13.5 statistical software. Results: 1 there was no significant difference in age and body mass index (Body mass index,BMI) between OSAHS group and normal control group (P0.05). 2the serum TNF- 伪 levels in OSAHS patients were 17.52 卤2.20pg / ml, 25.05 卤3.89pg / ml, 43.29 卤12.95pg / ml in mild group, 25.05 卤3.89pg / ml in moderate group and 43.29 卤12.95pg / ml in severe group, which were higher than that in normal control group (11.03 卤4.22pg / ml). The difference was statistically significant (p 0.01), and the more severe the OSAHS, the higher the content of TNF- 伪. 3. The serum levels of iron modulin in OSAHS patients were 585.51 卤111.99pg / ml, 949.24 卤168.45pg / ml, 1890.95 卤495.54pg/ml, respectively, which were significantly higher than those in normal controls (375.70 卤91.47pg / ml). The difference was statistically significant (p0.01), and the more severe the OSAHS, the higher the iron content. (4) there was a significant positive correlation between serum TNF- 伪 and iron modulin in OSAHS group. (r = 0.728, p 0.01). There was a significant positive correlation between serum TNF- 伪 and (AHI) of sleep apnea hypopnea index (r = 0.723, P < 0.05). The levels of serum TNF- 伪 and iron modulin were negatively correlated with the lowest SPO2 in sleep monitoring. Conclusion: 1 the serum TNF-a, in OSAHS group was negatively correlated with the lowest SPO2 in sleep monitoring. (conclusion: 1) in the OSAHS group, the levels of serum TNF- 伪 and iron modulin were negatively correlated with the lowest SPO2 in sleep monitoring. (conclusion: 1) the level of serum TNF-a, in OSAHS group was negatively correlated with the lowest SPO2 in sleep monitoring. The level of iron modulin expression in serum was significantly higher than that in the normal control group, indicating that the abnormal expression of TNF- 伪 and iron modulin in serum was related to the condition of OSAHS patients. 2. The comparison of serum TNF- 伪, iron modulin and OSAHS showed that the more serious the condition of OSAHS, the higher the expression level of OSAHS. 3There was a significant positive correlation between the expression of serum TNF-a, iron and sleep apnea hypopnea index in OSAHS group, and a significant negative correlation with the lowest SpO2 in sleep monitoring, which indicated that the expression of irontin in serum was correlated with the severity of OSAHS. 4. Serum TNF- 伪 and iron modulin can be used as a biological index of OSAHS severity.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R766

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