發(fā)布時(shí)間：2018-05-08 05:24

  本文選題：阻塞性睡眠呼吸暫停低通氣綜合征 + 低氧誘導(dǎo)因子-1α��； 參考：《青海大學(xué)》2017年碩士論文

【摘要】：目的:探討阻塞性睡眠呼吸暫停低通氣綜合征(obstructive sleep apnea/hypopnea syndrome,OSAHS)患者與健康對(duì)照組血清低氧誘導(dǎo)因子-1α(hypoxic inducible factor-1α,HIF-1α)、低氧誘導(dǎo)因子-2α(hypoxic inducible factor-2α,HIF-2α)的表達(dá)水平差異,進(jìn)一步了解OSAHS人群在慢性間歇性低氧下血清HIF-1α、HIF-2α的水平變化及其意義。方法:選取2015年12月~2016年12月在青海大學(xué)附屬醫(yī)院呼吸內(nèi)科睡眠監(jiān)測(cè)室行多導(dǎo)睡眠監(jiān)測(cè)(polysomnography,PSG)檢查后確診為OSAHS的西寧地區(qū)漢族男性患者為病例組,共41例。對(duì)照組選取在我院體檢中心體檢結(jié)果正常的健康男性,詳細(xì)詢問(wèn)病史,嚴(yán)格按照納入標(biāo)準(zhǔn)及排除標(biāo)準(zhǔn)并經(jīng)PSG檢查排除睡眠疾患,在年齡、性別、居住海拔等一般情況上與病例組相匹配,共32例。于清晨空腹收集外周靜脈血,采用定量酶聯(lián)免疫吸附試驗(yàn)法檢測(cè)血清中HIF-1α、HIF-2α的濃度。結(jié)果:1.OSAHS組呼吸暫停低通氣指數(shù)、氧減指數(shù)、氧飽和度低于90%所累積時(shí)間占總睡眠時(shí)間百分比均顯著高于對(duì)照組(P0.001),分別為([57.8(29.9,70.8)]次/h vs.[1.5(1.0,2.3)]次/h)、([59.4(33.3,75.7)]次/h vs.[3.0(1.5,5.2)]次/h)、([84.0(37.8,95.9)]%vs.[1.7(0.4,12.4)]%);而平均氧飽和度、最低氧飽和度、清晨氧飽和度均顯著低于對(duì)照組(P0.001),分別為([87.0(83.0,89.5)]%vs.[92.0(91.0,92.8)]%)、([65.0(54.5,72.5)]%vs.[85.5(83.3,86.0)]%)、([90.0(88.5,92.0)]%vs.[94.0(93.0,96.0)]%)。2.OSAHS組與對(duì)照組間清晨血清中HIF-1α與HIF-2α表達(dá)水平無(wú)顯著差異(P0.05),分別為([21.357(15.330,23.446)]pg/m L vs.[19.016(13.274,22.812)]pg/m L)、([52.121(30.932,57.003)]pg/m L vs.[41.642(36.242,44.841)]pg/m L)。3.OSAHS患者血清HIF-1α與HIF-2α表達(dá)水平與呼吸暫停低通氣指數(shù)、平均氧飽和度、最低氧飽和度、氧飽和度低于90%所累積時(shí)間占總睡眠時(shí)間百分比、清晨氧飽和度均無(wú)線性相關(guān)關(guān)系(P0.05)。結(jié)論:OSAHS患者與對(duì)照組清晨血清HIF-1α與HIF-2α水平無(wú)顯著差異,考慮間歇低氧狀態(tài)下HIF-1α與HIF-2α的變化可能為脈沖式,清晨氧飽和度水平不足以刺激HIF-1α與HIF-2α改變,也提示OSAHS患者清晨醒時(shí)的血清不能充分反映OSAHS夜間間歇低氧的相關(guān)變化。
[Abstract]:Objective: to investigate the difference of serum hypoxia inducible factor 1 偽 peroxia inducible factor-1 偽 (HIF-1 偽), hypoxia inducible factor 2 偽 peroxic inducible factor-2 偽 (HIF-2 偽) in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) and healthy control group, and to investigate the expression of HIF-2 偽 in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). To study the changes and significance of serum HIF-1 偽 -HIF-2 偽 in OSAHS patients under chronic intermittent hypoxia. Methods: from December 2015 to December 2016, 41 male Han Chinese patients in Xining were selected as the case group, who were diagnosed as OSAHS by polysomnography and polysomnography in sleep monitoring room of Department of Apnea, affiliated Hospital of Qinghai University. The control group selected healthy male who had normal physical examination result in our hospital physical examination center, inquired the medical history in detail, strictly according to the inclusion standard and the exclusion standard and the PSG examination excluded the sleep disease, in age, the gender, There were 32 cases which were matched with the case group in general, such as living altitude and so on. Peripheral venous blood was collected on an empty stomach in the morning. The concentration of HIF-1 偽 -HIF-2 偽 in serum was detected by quantitative enzyme linked immunosorbent assay (Elisa). Results 1. The apnea hypopnea index, oxygen desaturation index and oxygen saturation in the OSAHS group were significantly higher than those in the control group (P 0.001), which were respectively (57.829.970.8) times of apnea hypopnea index, oxygen reduction index and oxygen saturation less than 90% of the total sleep time, which were respectively ([57.829.970.8) times / h vs. [1.5v / 1.0 / 2.3s] / r / h ([59.40.33 / 75.75.7] / h vs. [3.01.55.2)] / (84.037.895.995 / 9) vs. Minimum oxygen saturation, 娓呮櫒姘чケ鍜屽害鍧囨樉钁椾綆浜庡鐓х粍(P0.001),鍒嗗埆涓，

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