本文選題：阻塞性睡眠呼吸暫停低通氣綜合癥 + 血清鐵調(diào)素��； 參考：《昆明醫(yī)科大學(xué)》2016年碩士論文

【摘要】：[目的]近年來(lái)對(duì)OSAHS的發(fā)生發(fā)展、相關(guān)疾病、診斷治療都有大量的研究,并發(fā)現(xiàn)該病與血液中多種因子的改變相關(guān)。鐵調(diào)素的發(fā)現(xiàn)僅十余年,對(duì)其化學(xué)結(jié)構(gòu)、生理功能以及影響因素等有一定的了解,但OSAHS和血清鐵調(diào)素的相關(guān)性,在國(guó)內(nèi)外報(bào)道甚少。本課題將研究OSAHS治療前后鐵調(diào)素的變化的相關(guān)臨床研究,以此評(píng)估其能否成為對(duì)OSAHS預(yù)后療效判定中的生物學(xué)指標(biāo)之一。[方法]本研究隨機(jī)選取2013年12月-2015年3月昆明醫(yī)科大學(xué)第二附屬醫(yī)院確診中重度OSAHS患者共計(jì)66人(其AHI均大于15),均依據(jù)其上氣道梗阻情況,相應(yīng)給予H-UPPP和／或鼻中隔偏曲矯正手術(shù)+鼻甲部分切除術(shù)治療。根據(jù)術(shù)前、術(shù)后6個(gè)月PSG檢測(cè)結(jié)果將患者分為治療有效組(53人)和治療無(wú)效組(13人),測(cè)量各組術(shù)前及術(shù)后鐵調(diào)素水平。將所有數(shù)據(jù)用SPSS 20.0統(tǒng)計(jì)軟件進(jìn)行處理分析。[結(jié)果]OSAHS患者治療有效組與治療無(wú)效組的手術(shù)前后體重指數(shù)(BMI)差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。治療有效組OSAHS術(shù)前血清鐵調(diào)素水平1202.33±460.86Pg/ml,與OSAHS術(shù)后6個(gè)月730.36±364.46Pg/ml相比,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療無(wú)效組術(shù)前血清鐵調(diào)素水平1326.31±302.67Pg/m1與術(shù)后6個(gè)月1142.27±243.16Pg/ml相比,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。無(wú)論是術(shù)前還是術(shù)后OSAHS患者血清鐵調(diào)素與AHI均呈正相關(guān)(r=0.791,P0.05)術(shù)前與術(shù)后OSAHS患者血清鐵調(diào)素的水平與睡眠監(jiān)測(cè)中的最低SP02呈顯著負(fù)相關(guān)(r=-0.741,p0.05)。[結(jié)論]無(wú)論術(shù)前或術(shù)后OSAHS患者血清鐵調(diào)素的表達(dá)與睡眠呼吸暫停低通氣指數(shù)呈顯著正相關(guān),與多導(dǎo)睡眠監(jiān)測(cè)最低SP02呈顯著負(fù)相關(guān),說(shuō)明鐵調(diào)素水平與OSAHS病情程度相關(guān)。術(shù)后6個(gè)月AHI減小≥50%(治療有效組)的OSAHS患者血清鐵調(diào)素水平較術(shù)前明顯降低,差異有統(tǒng)計(jì)學(xué)意義,而術(shù)后6個(gè)月AHI減小50%(治療無(wú)效組)的OSAHS患者血清鐵調(diào)素水平較術(shù)前有所降低,差異無(wú)統(tǒng)計(jì)下意義。鐵調(diào)素可以評(píng)價(jià)OSAHS手術(shù)后患者病情恢復(fù)情況。血清鐵調(diào)素可以作為評(píng)估OSAHS嚴(yán)重程度及OSAHS手術(shù)效果的生物學(xué)指標(biāo)。
[Abstract]:[objective] in recent years, the occurrence and development of OSAHS, related diseases, diagnosis and treatment have been a lot of research, and found that the disease is related to the changes of many factors in the blood. Iron modulin has been discovered only for more than ten years and has a certain understanding of its chemical structure physiological function and influencing factors. However the correlation between OSAHS and serum iron modulin is rarely reported at home and abroad. In this study, we will study the changes of iron modulin before and after OSAHS treatment, and evaluate whether it can be used as a biological index in judging the prognosis of OSAHS. [methods] A total of 66 patients with moderate and severe OSAHS were randomly selected from the second affiliated Hospital of Kunming Medical University from December 2013 to March 2015. Their AHI were all greater than 15, all according to their upper airway obstruction. H-UPPP and / or nasal septum deviation correction surgery was given to the treatment of partial turbinate resection. According to the results of preoperative and postoperative PSG test, the patients were divided into two groups: the effective group (53 patients) and the ineffective group (13 patients). The levels of iron modulin were measured before and after operation. All the data were processed and analyzed by SPSS 20.0 statistical software. [results] there was no significant difference in body mass index (BMI) between effective and ineffective OSAHS patients before and after operation (P 0.05). In the effective group, the serum iron modulin level before OSAHS was 1202.33 鹵460.86 PG / ml, which was significantly higher than that at 6 months after OSAHS (730.36 鹵364.46Pg/ml). There was no significant difference in serum iron modulin levels (1326.31 鹵302.67Pg/m1) before operation and 1142.27 鹵243.16Pg/ml (6 months after operation) between the ineffective group and the control group (P 0.05). There was a positive correlation between serum iron modulin and AHI in both preoperative and postoperative OSAHS patients (P 0.05). There was a significant negative correlation between the level of serum iron modulin and the lowest SP02 in sleep monitoring in OSAHS patients before and after operation. [conclusion] the expression of serum iron in patients with OSAHS was positively correlated with sleep apnea hypopnea index and negatively correlated with the lowest SP02 monitored by polysomnography, indicating that the level of iron was correlated with the severity of OSAHS. 6 months after operation, the serum levels of iron modulin in OSAHS patients whose AHI decreased more than 50% (effective group) were significantly lower than those before operation, and the difference was statistically significant. At 6 months after operation, the level of serum iron modulin in OSAHS patients with AHI decreased by 50% (ineffective group) was lower than that before operation, and there was no statistical significance between the two groups. Iron tone can be used to evaluate the recovery of patients after OSAHS operation. Serum iron modulin can be used as a biological index to evaluate the severity of OSAHS and the effect of OSAHS surgery.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R766.9

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