發(fā)布時間：2018-03-05 04:31

  本文選題：阻塞性睡眠呼吸暫停綜合征　切入點：脂肪細胞脂肪酸結(jié)合蛋白　出處：《山東大學(xué)》2010年碩士論文　論文類型：學(xué)位論文

【摘要】： 背景：脂肪細胞脂肪酸結(jié)合蛋白(adipocyte-fatty acid binding protein, A-FABP)是新近發(fā)現(xiàn)的一種細胞內(nèi)的重要的溶質(zhì)蛋白,屬于脂肪酸結(jié)合蛋白大家族,最早在脂肪組織中被發(fā)現(xiàn),現(xiàn)發(fā)現(xiàn)其廣泛存在于各種正常的組織細胞中,并可以由脂肪細胞分泌到血液,在血液循環(huán)中穩(wěn)定存在。A-FABP可以促進脂肪酸的代謝和轉(zhuǎn)運,與糖脂代謝及炎癥反應(yīng)有密切的關(guān)系。近年來的多種臨床及動物實驗均表明A-FABP與阻塞性睡眠呼吸暫停綜合征(obstructive sleep apnea syndrome, OSAS)有明顯的相關(guān)性。我們主要通過對患者血清A-FABP的檢測,揭示A-FABP在OSAS患者與正常人之間水平的差異,探討A-FABP與OSAS之間的關(guān)系。 方法：依據(jù)中華醫(yī)學(xué)會耳鼻咽喉科學(xué)分會、中華耳鼻咽喉科學(xué)雜志編委會2002年杭州會議關(guān)于阻塞性睡眠呼吸暫停綜合征的診斷標(biāo)準(zhǔn),選擇2009年1月至2010年2月在山東大學(xué)第二醫(yī)院診斷為阻塞性睡眠呼吸暫停綜合征的門診或住院的患者25例為實驗組,年齡32～60歲(43.12±9.84歲),均為男性,均經(jīng)多導(dǎo)睡眠監(jiān)測(polysomnography, PSG)證實。另選無睡眠打鼾及呼吸暫停的15例作為正常對照組,年齡22～66歲(43.87±12.83歲),亦均為男性。兩組均無高血壓及糖尿病病史,無高脂血癥及心血管疾病,年齡差別無顯著性。測量并記錄所有受試者的身高、體重,計算體質(zhì)量指數(shù)(body mass index, BMI)。采用酶聯(lián)免疫分析法(enzyme-linked immunosorbent assays, ELISA)檢測其血清中A-FABP的濃度。 結(jié)果：OSAS患者血清A-FABP的濃度為35.68±10.11 ng／m1,高于正常對照組18.61±7.26 ng／ml,二者之間的差異有顯著性(t=5.75,P0.05)。將A-FABP值與睡眠呼吸暫停低通氣指數(shù)(apnea-hypopnea index, AHI)、最低血氧飽和度、最長呼吸暫停時間、呼吸暫停及低通氣總時間、呼吸暫�？偞螖�(shù)、氧減指數(shù)做相關(guān)分析,發(fā)現(xiàn)A-FABP與AHI、呼吸暫停及低通氣總時間、呼吸暫�？偞螖�(shù)、氧減指數(shù)呈正相關(guān)(P0.05),與最低血氧飽和度呈負相關(guān)(P0.05),與最長呼吸暫停時間無明顯相關(guān)性(P0.05)。將病例組根據(jù)AHI分為輕中重三組,輕度(5≤AHI20, A-FABP 25.7±94.90 ng/ml),中度(20≤AHI40, A-FABP 34.55±5.23 ng/ml),重度(AHI≥40, A-FABP 41.44±9.92 ng/ml),發(fā)現(xiàn)A-FABP隨著OSAS程度的加重而增加。 結(jié)論：脂肪細胞脂肪酸結(jié)合蛋白在阻塞性睡眠呼吸暫停綜合征患者血清中的水平較正常對照組偏高,且與阻塞性睡眠呼吸暫停綜合征的嚴(yán)重程度有著明顯的相關(guān)性。
[Abstract]:Background: adipocyte-fatty acid binding protein (A-FABP-) is a recently discovered solute protein in cells, which belongs to the large family of fatty acid binding proteins and was first found in adipose tissue. It has been found that it exists widely in various normal tissue cells and can be secreted into the blood by adipocytes. The stable presence of .A-FABP in blood circulation can promote the metabolism and transport of fatty acids. In recent years, a variety of clinical and animal experiments have shown that A-FABP has a significant correlation with obstructive sleep apnea syndrome (OSASs). To explore the relationship between A-FABP and OSAS in patients with OSAS and normal subjects. Methods: according to the diagnostic criteria of obstructive sleep apnea syndrome (OSAS), the editorial Committee of the Chinese Journal of Otolaryngology and Otolaryngology of the Chinese Medical Association and the editorial Committee of the Chinese Journal of Otolaryngology, 2002. From January 2009 to February 2010, 25 patients diagnosed as obstructive sleep apnea syndrome (OSAS) in the second Hospital of Shandong University were selected as experimental group, aged 32 to 60 years old, 43.12 鹵9.84 years old, all of them were male. All patients were confirmed by polysomnography (PSG). 15 patients without sleep snoring and apnea were selected as normal control group, aged 226.66 years old, 43.87 鹵12.83 years old, all of them were male. Both groups had no history of hypertension and diabetes, no hyperlipidemia and cardiovascular disease. Age difference was not significant. The height and weight of all the subjects were measured and recorded. The body mass index (BMI) was calculated. The serum A-FABP concentration was detected by enzyme-linked immunosorbent assays (ELISAs). Results the concentration of A-FABP in the patients with OSAS was 35.68 鹵10.11 ng / ml, which was higher than that in the control group (18.61 鹵7.26 ng / ml). There was a significant difference between A-FABP and apnea-hypopnea index (AHIO _ 2), the longest apnea duration, and the apnea-hypopnea index. The total time of apnea and hypopnea, the total number of apnea, oxygen reduction index, A-FABP and AHI, the total time of apnea and hypopnea, the total number of apnea, the total number of apnea, There was a positive correlation between oxygen reduction index (P 0.05), negative correlation with minimum oxygen saturation (P 0.05) and no significant correlation with the longest apnea time (P 0.05). The case group was divided into three groups according to AHI. Mild 5 鈮，

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