本文選題：阻塞性睡眠呼吸暫停低通氣綜合征 + T淋巴細(xì)胞亞群�。� 參考：《福建中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:分析成人阻塞性睡眠呼吸暫停低通氣綜合征(Obstructive sleep apnea hypopnea syndrome,OSAHS)患者外周血清癌胚抗原(Cancer embryo antigen,CEA)和T淋巴細(xì)胞亞群(T lymphocyte subsets,T-LS)水平的變化,了解該類患者與健康人群CEA及T-LS水平的差異性;探討OSAHS患者免疫功能的變化及OSAHS與癌癥的相關(guān)性,檢驗(yàn)OSAHS患者癌胚抗原水平變化是否與T-LS水平變化有關(guān)。方法:選擇2015年3月至2017年1月期間莆田學(xué)院附屬醫(yī)院呼吸內(nèi)科門診及住院確診為OSAHS的患者85例為OSAHS組,按病情的嚴(yán)重程度將患者分為輕度組、中度組、重度組,按病程長短將患者分為長病程組(5年)和短病程組(5年),同期選擇門診健康體檢者32例作為對照組。檢測所有研究對象外周血清CEA和T-LS水平,比較各組之間外周血清CEA和T-LS水平的差異。同時(shí)記錄所有研究對象多導(dǎo)圖睡眠監(jiān)測中呼吸暫停低通氣指數(shù)(apnea hypopnea index,AHI)和最低血氧飽和度(lowest Oxygen saturation,LSa02)監(jiān)測結(jié)果,分析 OSAHS 患者外周血清 CEA、T-LS、AHI 及 LSaO2之間的關(guān)系。結(jié)果:(1)與對照組比較,OSAHS組患者血清CD3+CD4+T細(xì)胞百分率和CD4+/CD8+比值明顯下降(P0.05),CEA水平升高(P0.05),而CD3+和CD3+CD8+T細(xì)胞百分率均無顯著差異(P0.05)。(2)不同OSAHS病情分組比較:各組之間血清CD3+和CD3+CD8+T細(xì)胞百分率均無顯著差異(P0.05)。輕度組和中度組患者血清CD3+CD4+T細(xì)胞百分率均明顯低于對照組(P0.05),重度組患者血清CD3+CD4+T細(xì)胞百分率明顯低于對照組、輕度組和中度組(P0.05)。輕度組和中度組患者之間的血清CD3+CD4+T細(xì)胞百分率無顯著差異(P0.05)。重度組患者CD4+/CD8+比值明顯低于對照組、輕度組和中度組,中度組CD4+/CD8+比值明顯低于對照組,差異均具有顯著意義(P0.05)。而對照組和輕度組之間的CD4+/CD8+比值無明顯差異(P0.05)。重度組患者血清CEA水平明顯高于對照組、輕度組和中度組,差異均具有顯著意義(P0.05)。而對照組、輕度組和中度組三組之間的血清CEA均無明顯差異(P0.05)。(3)不同OSAHS病程分組比較:長病程組患者血清CD3+T淋巴細(xì)胞百分率低于對照組和短病程組(P0.05),CEA水平明顯高于對照組和短病程組(P0.05)。對照組和短病程組之間CD3+T細(xì)胞百分率和CEA水平均無顯著差異(P0.05)。三組之間的血清CD3+CD8+T淋巴細(xì)胞百分率無顯著差異(P0.05)。長病程組CD3+CD4+T細(xì)胞百分率明顯低于對照組和短病程組(P0.05),短病程組CD3+CD4+T細(xì)胞百分率明顯低于對照組(P0.05)。對照組患者的CD4+/CD8+比值高于短病程組和長病程組(P0.05)。短病程組和長病程組之間的CD4+/CD8+比值無顯著差異(P0.05)。(4)對OSAHS組AHI、LSa02、T-LS及CEA進(jìn)行相關(guān)性分析,結(jié)果顯示:OSAHS組患者CD3+T細(xì)胞水平與AHI、LSaO2和CEA均不存在相關(guān)性(P0.05)。OSAHS組患者CD3+CD4+T細(xì)胞水平與AHI、LSaO2和CEA均存在顯著相關(guān)性(P0.01),其中CD3+CD4+T細(xì)胞水平與AHI和CEA水平呈負(fù)相關(guān),與LSaO2呈正相關(guān)。OSAHS組患者CD3+CD8+T細(xì)胞水平與AHI、LSa02均存在相關(guān)性(P0.05),其中CD3+CD8+T細(xì)胞水平與AHI呈正相關(guān),與LSaO2呈負(fù)相關(guān)。CD3+CD8+T細(xì)胞水平與CEA水平不存在相關(guān)性(P0.05)。OSAHS組患者外周血清CD4+/CD8+比值與AHI、LSaO2和CEA均存在顯著相關(guān)性(P0.01),其中CD4+/CD8+比值與AHI和CEA水平呈負(fù)相關(guān),與LSa02呈正相關(guān)。OSAHS組患者外周血清CEA水平與AHI、LSa02均存在顯著相關(guān)性(P0.01),其中CEA水平與AHI呈正相關(guān),與LSaO2呈負(fù)相關(guān)。結(jié)論:1、OSAHS患者體內(nèi)存在T-LS水平改變,且與病情嚴(yán)重程度及病程長短相關(guān),提示OSAHS患者可能存在不同程度的免疫功能下降。2、OSAHS患者體內(nèi)存在血清CEA水平升高,主要集中在長病程和重度的OSAHS患者。3、OSAHS患者體內(nèi)血清CEA和T-LS水平與AHI、LSa02均存在線性相關(guān),說明AHI和LSa02可能是影響OSAHS患者免疫功能和CEA水平的因素之一。4、OSAHS患者體內(nèi)CEA水平與CD3+CD4+T細(xì)胞水平、CD4+/CD8+比值均存在線性相關(guān),說明OSAHS患者體內(nèi)血清CEA水平升高可能與其免疫功能下降有關(guān)。
[Abstract]:Objective: to analyze the changes of peripheral serum carcinoembryonic antigen (Cancer embryo antigen, CEA) and T lymphocyte subsets in patients with adult obstructive sleep apnea hypopnea syndrome (Obstructive sleep apnea hypopnea syndrome, OSAHS). To investigate the changes of immune function in OSAHS patients and the correlation between OSAHS and cancer, and to examine whether the change of the level of carcinoembryonic antigen in OSAHS patients is related to the level of T-LS. Methods: 85 patients with OSAHS in the respiratory department of Affiliated Hospital of Putian College from March 2015 to January 2017 were selected as OSAHS group, according to the severe course of the disease. The patients were divided into mild group, moderate group and severe group. The patients were divided into long course group (5 years) and short course group (5 years) according to the duration of the disease, and 32 cases in the same period were selected as the control group. The serum CEA and T-LS levels of all the subjects were measured, and the difference of serum CEA and T-LS levels between each group was compared. The monitoring results of the apnea hypopnea index (AHI) and the lowest oxygen saturation (lowest Oxygen saturation, LSa02) in the sleep monitoring of subjects were studied. The relationship between CEA, T-LS, AHI, and LSa02 in the peripheral serum of patients with OSAHS was analyzed. (1) compared with the control group, the percentage of serum cells in the patients was compared with the control group. The ratio of rate to CD4+/CD8+ decreased significantly (P0.05) and the level of CEA increased (P0.05), but there was no significant difference in the percentage of CD3+ and CD3+CD8+T cells (P0.05). (2) the percentages of CD3+ and CD3+CD8+T cells in serum were not significantly different among the different OSAHS cases (P0.05). The percentage of the serum CD3+CD4+T cells in the mild and moderate groups were both obvious. The percentage of serum CD3+CD4+T cells in the severe group was significantly lower than that of the control group (P0.05). The percentage of serum CD3+CD4+T cells between the mild group and the moderate group was not significantly different (P0.05). The CD4+/CD8+ ratio in the severe group was significantly lower than that in the control group, the mild group and the moderate group, and the moderate group CD4+/CD8. The ratio of + to the control group was significantly lower than that of the control group (P0.05), but the CD4+/CD8+ ratio between the control group and the mild group was not significantly different (P0.05). The serum CEA level in the severe group was significantly higher than that in the control group. The difference between the mild group and the moderate group was significant (P0.05). The control group, the serum between the mild group and the moderate group, was between the three groups. There was no significant difference in CEA (P0.05). (3) the comparison of different OSAHS course groups: the percentage of serum CD3+T lymphocytes in the long course group was lower than the control group and the short course group (P0.05), and the CEA level was significantly higher than the control group and the short course group (P0.05). There was no significant difference between the percentage of CD3+T cells and the level of CEA between the control group and the short course group (P0.05). (P0.05). The percentage of CD3+CD8+T lymphocyte in serum was no significant difference (P0.05). The percentage of CD3+CD4+T cells in the long course group was significantly lower than that of the control group and the short course group (P0.05). The percentage of CD3+CD4+T cells in the short course group was significantly lower than that of the control group (P0.05). The CD4+/CD8+ ratio in the control group was higher than the short course group and the long course group (P0.05). There was no significant difference in the CD4+/CD8+ ratio between the long course group and the long course group (P0.05). (4) the correlation analysis of AHI, LSa02, T-LS and CEA in group OSAHS showed that there was no correlation between CD3+T cell level in OSAHS group and AHI, LSaO2 and CEA. The level of CD3+CD4+T cells was negatively correlated with the level of AHI and CEA, and there was a positive correlation between the level of CD3+CD8+T cell and LSa02 in the.OSAHS group with LSaO2 (P0.05), and the CD3+CD8+T cell level was positively correlated with AHI, and the negative correlation with LSaO2 was not associated with the level of the peripheral blood of the patients. There was a significant correlation between the ratio of CD4+/CD8+ and AHI, LSaO2 and CEA (P0.01), and the CD4+/CD8+ ratio was negatively correlated with the level of AHI and CEA, and there was a positive correlation between the CEA level of the peripheral serum and AHI, which was positively correlated with LSa02 in the.OSAHS group of the.OSAHS group. The change of memory at T-LS level is related to the severity of the disease and the duration of the disease, suggesting that OSAHS patients may have different levels of immune function.2, and the level of serum CEA in OSAHS patients is elevated, mainly in the long course and severe OSAHS patients.3, and the serum CEA and T-LS levels and AHI in the serum of OSAHS patients and the linearity of the LSa02 are linear. It is suggested that AHI and LSa02 may be one of the factors affecting the immune function and CEA level of OSAHS patients.4. The level of CEA in OSAHS patients is linearly related to the level of CD3+CD4+T cells and the ratio of CD4+/CD8+, indicating that the increase of CEA level in the serum of OSAHS patients may be related to the decrease of immune function.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R766

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