【摘要】：[目的]通過檢測不同患病程度的OSAHS患者外周血清中microRNA-181a濃度,分析其與多導(dǎo)睡眠監(jiān)測指標(biāo)的相關(guān)性,探討microRNA-181a的表達(dá)與OSAHS患者的關(guān)系。[方法]1、收集2016年9月至2017年1月期間前往昆明醫(yī)科大學(xué)第一附屬醫(yī)院頭頸鼾癥中心行多導(dǎo)睡眠監(jiān)測(Polysomnography,PSG)的男性患者41例,年齡35～65歲。根據(jù)中華醫(yī)學(xué)會OSAHS診治指南PSG結(jié)果進(jìn)行分組,其中輕度OSAHS組20例,中、重度OSAHS組21例。同時選取同時期進(jìn)行體檢的健康男性19名作為對照組。采集所有受試者基本信息及PSG檢查結(jié)果,均排除慢性肺部病變、高血壓及其他心腦血管疾病、糖尿病及其他內(nèi)分泌疾病、甲狀腺疾病、營養(yǎng)代謝疾病。既往無特殊藥物使用史,睡眠監(jiān)測前一周內(nèi)無上呼吸道感染或發(fā)熱史,戒煙戒酒≥1周,所有患者均知情同意。2、受試者取晨起空腹血樣3ml,血液樣品離體后立即置于無DNA酶和RNA酶的滅菌采血管中,自然靜置,800×g離心5min后采集血清,-80℃保存?zhèn)溆谩?、血清RNA提取:取上述血清樣本,按照miRcute miRNA提取試劑盒說明書所述的方法提取血清RNA。采用紫外分光光度法測定RNA濃度。4、miRNA逆轉(zhuǎn)錄合成cDNA,Q-PCR擴(kuò)增目的基因檢測miRNA水平。5、收集結(jié)果,并進(jìn)行數(shù)據(jù)分析及統(tǒng)計學(xué)處理。[結(jié)果]1、輕度OSAHS組患者血清中miR-18 1a表達(dá)水平(10.5±0.5)與正常組(10.2±0.1)相比,差異無統(tǒng)計學(xué)意義(P0.05);但中、重度OSAHS組患者血清中miR-181a表達(dá)水平(12.8±1.4)較正常組明顯升高,且差異有統(tǒng)計學(xué)意義(P0.05)。組間比較顯示,中、重度OSAHS組患者血清中miR-181a表達(dá)水平較輕度OSAHS組患者升高,且差異有統(tǒng)計學(xué)意義(P0.05)。提示OSAHS患者血清中miR-181a表達(dá)水平高于正常人,且中、重度OSAHS患者血清中miR-181a表達(dá)水平較輕度OSAHS患者升高(F=1 6.622,P0.001)。2、OSAHS患者血清中miR-181a表達(dá)水平與AHI、TS90%相關(guān)性分析均呈正相關(guān)(r值分別為0.752和0.778,均P0.01)。3、OSAHS患者血清中miR-181a表達(dá)水平與LSa02水平相關(guān)性分析呈負(fù)相關(guān)(r值為-0.388,P0.01)。[結(jié)論]1、隨OSAHS程度加重,miR-181a表達(dá)水平升高;隨AHI升高、TS90%增大,miR-181a表達(dá)水平升高;隨LSa02水平降低,miR-181a表達(dá)水平升高。2、miR-181a與OSAHS患者PSG各指標(biāo)密切相關(guān),兩者聯(lián)合應(yīng)用能進(jìn)一步提高對中、重度OSAHS的診斷效能及指導(dǎo)治療,同時協(xié)助評估CPAP的治療效果。
[Abstract]:[objective] to investigate the relationship between microRNA-181a expression and polysomnography in patients with OSAHS. [methods] from September 2016 to January 2017, 41 male patients, aged 35 or 65 years, who went to the head and neck snoring Center of the first affiliated Hospital of Kunming Medical University for polysomnography (Polysomnography,PSG) were collected. According to the PSG results of OSAHS diagnosis and treatment guidelines of the Chinese Medical Association, there were 20 cases in mild OSAHS group, 21 cases in moderate and severe OSAHS group. At the same time, 19 healthy men who underwent physical examination at the same time were selected as the control group. The basic information of all subjects and the results of PSG examination were all excluded from chronic pulmonary diseases, hypertension and other cardiovascular and cerebrovascular diseases, diabetes and other endocrine diseases, thyroid diseases and nutritional and metabolic diseases. There was no history of special drug use, no history of upper respiratory tract infection or fever within one week before sleep monitoring, smoking and alcohol cessation 鈮，

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