本文選題：阻塞性睡眠呼吸暫停低通氣綜合征 + 慢性間斷性低氧��； 參考：《中南大學(xué)》2012年碩士論文

【摘要】：目的： 通過觀察慢性間斷性低氧大鼠模型血清中PTX3、HIF-1α的水平,并觀測在抗氧化劑N-乙酰半胱氨酸(N-acetylcysteine, NAC)干預(yù)后上述因子的含量變化和中重度OSAHS患者血清中PTX3、HIF-1α的水平及其在CPAP治療后上述因子含量變化,探討慢性間斷缺氧對OSAHS患者血漿PTX3、HIF-1α的水平影響及可能機制。 方法：實驗分為兩部分。 第一部分：通過臨床多導(dǎo)睡眠監(jiān)測收集病例,設(shè)立正常對照組(A組)和中重度OSAHS(B組)、中重度OSAHS治療組(C組)3個實驗組。記錄OSAS組患者的呼吸暫停低通氣指數(shù)(Apnea Hypopnea Index, AHI)、最低血氧飽和度(Lowest Oxygen Saturation, LS02)以及血氧飽和度低于90%時間占總睡眠時間百分比(T-SaO290%),并于次日晨起睡眠監(jiān)測結(jié)束后采集靜脈血,自然靜置1小時后用離心機以3000r／min離心10分鐘,然后收集標本上層液置于Eppendorf管中。標本置于-70℃低溫冰箱保存,待批量以ELISA法分別測定血清中PTX3、HIF-1α濃度。中重度OSAHS治療組(C組)患者給予CPAP治療1月后,再次行多導(dǎo)睡眠監(jiān)測并次日晨起睡眠監(jiān)測結(jié)束后采集靜脈血,待批量以ELISA法分別測定血清中PTX3、HIF-1α濃度。 第二部分：24只SD雄性大鼠采用隨機排列表法分為慢性間斷低氧組(CIH1)、慢性間斷低氧+NAC干預(yù)組(CIH2)、慢性間斷低氧+生理鹽水組(CIH3)、和常氧對照組(NC組),每組6只。CIH1、CIH2、CIH3三組大鼠均置同—自制有機玻璃艙內(nèi),給予低氧循環(huán)即壓縮空氣和氮氣(180s為—循環(huán),艙內(nèi)氧濃度最低達6%-8%,維持20-25s,然后氧濃度恢復(fù)至21%,如此低氧循環(huán)7h/d)；NC組大鼠常規(guī)飼養(yǎng)即常氧(Fi0221%)。CIH2組給予NAC(800mg.kg-1.d-1)腹腔注射,CIH3組予生理鹽水(4m1.kg-1.d-1)腹腔注射。均于實驗后第六周處死各組大鼠。取心臟血,靜置2小時,予離心機以1000轉(zhuǎn)/分*10分鐘分離血清,分裝后置—70℃冰箱儲存待檢。以ELISA法分別測定血清中PTX3、HIF-1α濃度。 結(jié)果： 第一部分：中重度OSAHS患者血清PTX3與HIF-1α含量較對照組升高(P0.05),PTX3、HIF-1α水平呈正相關(guān)(r=0.281,P0.05),中重度OSAHS患者血清PTX3、HIF-1α水平與呼吸暫停低通氣指數(shù)(AHI)正相關(guān)(r分別為0.311,0.485,P0.05)、與血氧飽和度低于90%時間占總睡眠時間百分比正相關(guān)(r分別為0.349,0.444,P0.05),與最低血氧水平負相關(guān)(r分別為-0.327,-0.535,P0.05)。經(jīng)CPAP治療,中重度OSAHS患者血清PTX3、HIF-1α水平與治療前比較明顯降低(P0.05)。 第二部分：第六周時,CIH1、CIH3組大鼠與NC組比較血清PTX3、HIF-1α顯著升高(P0.05)；CIH2組與CIH1、CIH3組比較,血清PTX3、HIF-1α水平降低(P0.05)。 結(jié)論： 1.血清PTX3、HIF-1α水平在中重度OSAHS患者中明顯升高,與中重度OSAHS患者的AHI及低氧程度正相關(guān),且通過CPAP治療后其水平明顯降低。提示中重度OSAHS患者血清PTX3、HIF-1α水平升高可能與CIH有關(guān),糾正CIH能降低其水平。 2.CIH大鼠血清PTX3、HIF-1α水平升高,進一步證實,慢性間斷低氧是導(dǎo)致血清PTX3、HIF-1α水平升高的重要原因。 3.抗氧化劑NAC干預(yù)后可降低CIH大鼠血清PTX3、HIF-1α水平,提示CIH致血清PTX3、HIF-1α水平升高的機制可能與氧化應(yīng)激有關(guān)。
[Abstract]:Objective:
By observing the level of PTX3, HIF-1 alpha in the serum of chronic intermittent hypoxia rat model, and observing the changes of the above factors after the intervention of the antioxidant N- acetylcysteine (N-acetylcysteine, NAC) and the level of PTX3, HIF-1 a in the serum of the moderate and severe OSAHS patients and the changes of the above factors after the treatment of CPAP, the chronic discontinuity was discussed. Effects of hypoxia on plasma levels of PTX3 and HIF-1 alpha in patients with OSAHS and possible mechanisms.
Methods: the experiment was divided into two parts.
The first part was to collect cases by clinical polysomnography and set up a normal control group (group A) and moderate to severe OSAHS (group B), and 3 experimental groups (group C) with moderate and severe OSAHS. The apnea hypopnea index (Apnea Hypopnea Index, AHI), the lowest oxygen saturation (Lowest Oxygen), and oxygen saturation were recorded in the OSAS group. The percentage of the total sleep time (T-SaO290%) was lower than 90%, and the venous blood was collected after the end of the morning sleep monitoring. After 1 hours, the centrifuge was centrifuged with 3000r / min for 10 minutes, and then the superfluid was collected in the Eppendorf tube. The specimens were stored at -70 centigrade cryogenic refrigerator, and the blood was determined by ELISA method respectively. In the middle and severe OSAHS treatment group (group C), the patients in the middle and severe OSAHS treatment group (group C) were treated with polysomnography again after January, and the venous blood was collected after the end of the morning sleep monitoring, and the concentration of PTX3 and HIF-1 a in the serum was measured by ELISA in the group of patients with moderate and severe OSAHS treatment (group C) after January.
The second part: 24 SD male rats were divided into chronic intermittent hypoxia group (CIH1), chronic intermittent hypoxia +NAC intervention group (CIH2), chronic intermittent hypoxia + physiological saline group (CIH3), and normal oxygen control group (NC group), each group of 6.CIH1, CIH2, CIH3 three rats were placed in the same homemade plexiglass capsule and given hypoxic circulation or compression. Air and nitrogen (180s - cycle, the lowest oxygen concentration in the cabin reached 6%-8%, maintained 20-25s, then the oxygen concentration was restored to 21%, so oxygen cycle 7h/d); the rats in group NC were given normal oxygen (Fi0221%).CIH2 group given NAC (800mg.kg-1.d-1) intraperitoneal injection, and the CIH3 group was injected with saline (4m1.kg-1.d-1) intraperitoneally. All of them were killed at sixth weeks after the experiment. Group rats. Take the heart blood for 2 hours, give the centrifuge to separate the serum with 1000 / *10 minutes and separate the post - 70 - C refrigerator to be checked. The concentration of PTX3 and HIF-1 a in serum is measured by ELISA method.
Result錛，

本文編號：1906354