本文選題：睡眠呼吸暫停低通氣綜合征　切入點(diǎn)：巨細(xì)胞移動(dòng)抑制因子　出處：《南華大學(xué)》2010年碩士論文　論文類型：學(xué)位論文

【摘要】： 目的 對(duì)重度阻塞性睡眠呼吸暫停低通氣綜合征(OSAHS)患者體內(nèi)術(shù)前術(shù)后巨噬細(xì)胞移動(dòng)抑制因子(MIF)與可溶性CD40配體(sCD40L)濃度水平進(jìn)行檢測(cè),探討MIF及sCD40L與患者疾病的相關(guān)性,同時(shí)探討MIF與sCD40L在患者體內(nèi)的相關(guān)性,更進(jìn)一步了解患者體內(nèi)氧化應(yīng)激與炎癥反應(yīng)及相關(guān)炎癥因子之間的關(guān)系。為OSAHS的診斷和治療提供新的依據(jù)。 方法 將已經(jīng)通過PSG監(jiān)測(cè)診斷為重度OSAHS的男性患者29例設(shè)為實(shí)驗(yàn)組,選取29例健康男性作為對(duì)照組。應(yīng)用酶聯(lián)免疫吸附法(ELISA)對(duì)各組血清巨噬細(xì)胞移動(dòng)抑制因子(MIF)及sCD40L水平進(jìn)行檢測(cè),對(duì)OSAHS組進(jìn)行改良腭咽成形術(shù),解除其呼吸道阻塞,于術(shù)后6個(gè)月對(duì)OSAHS患者復(fù)查PSG。同時(shí)復(fù)查血清巨噬細(xì)胞移動(dòng)抑制因子(MIF)及sCD40L。將所得結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)分析,觀察手術(shù)前后患者血清巨細(xì)胞移動(dòng)抑制因子(MIF)及sCD40L水平的變化,了解實(shí)驗(yàn)組與對(duì)照組血清巨細(xì)胞移動(dòng)抑制因子(MIF)及sCD40L水平差異,同時(shí)觀察PSG各項(xiàng)指標(biāo)的變化。 結(jié)果 1.手術(shù)前后PSG各項(xiàng)指標(biāo)變化 OSAHS患者術(shù)前術(shù)后PSG監(jiān)測(cè)主要指標(biāo)對(duì)比,各測(cè)值均用X±s表示,各組的數(shù)據(jù)應(yīng)用配對(duì)t檢驗(yàn)進(jìn)行統(tǒng)計(jì)學(xué)分析,發(fā)現(xiàn)術(shù)后血氧飽和度上升(術(shù)前65.58±11.35,術(shù)后84.55±4.33)(P0.000),呼吸紊亂指數(shù)(AHI)下降(術(shù)前59.74±17.74,術(shù)后20.97±9.94)(P0.000),有顯著差異性。 2.手術(shù)前后患者M(jìn)IF血清濃度變化 各組MIF(術(shù)前術(shù)后對(duì)照組)水平比較,結(jié)果用X±s表示,術(shù)前術(shù)后組比較應(yīng)用配對(duì)t檢驗(yàn),術(shù)前、術(shù)后與對(duì)照組比較應(yīng)用兩樣本t檢驗(yàn)。OSAHS患者術(shù)后6個(gè)月血清MIF值有顯著下降(術(shù)前4.03±0.78ng/ml,術(shù)后2.89±0.75ng/ml)(P0.000),術(shù)前組與對(duì)照組(術(shù)前4.03±0.78ng/ml,對(duì)照組2.33±0.56ng/ ml)(P0.000),術(shù)后組與對(duì)照組(術(shù)后2.89±0.75ng/mll,對(duì)照組2.33±0.56ng/ ml)(P=0.003)。術(shù)前、術(shù)后MIF濃度與對(duì)照組比較差異均有顯著性,術(shù)后較術(shù)前顯著降低。 3.手術(shù)前后患者血清sCD40L水平變化 各組sCD40L (術(shù)前術(shù)后對(duì)照組)水平比較,結(jié)果用X±s表示,術(shù)前、術(shù)后組比較應(yīng)用配對(duì)t檢驗(yàn),術(shù)前、術(shù)后與對(duì)照組比較應(yīng)用兩樣本t檢驗(yàn)。OSAHS患者術(shù)后6個(gè)月血清sCD40L值有顯著下降(術(shù)前6.68±1.63ng/ml,術(shù)后4.50±1.10 ng/ml)(P0.000),術(shù)前組與對(duì)照組(術(shù)前6.68±1.63ng/ml,對(duì)照組3.11±0.69ng/ml)(P0.000),術(shù)后組與對(duì)照組(術(shù)后4.50±1.10 ng/ml,對(duì)照組3.11±0.69ng/ml)(P0.05)。術(shù)前、術(shù)后sCD40L濃度與對(duì)照組比較差異均有顯著性,術(shù)后較術(shù)前顯著降低。 結(jié)論 1. MIF和sCD40L在重度OSAHS患者血清中濃度升高。 2.術(shù)后6個(gè)月MIF及sCD40L均有顯著下降。 3.OSAHS患者血清MIF及sCD40L呈正相關(guān)關(guān)系。 4. MIF和sCD40L可以作為OSAHS患者手術(shù)療效評(píng)判的重要指標(biāo)。
[Abstract]:objective
For severe obstructive sleep apnea hypopnea syndrome (OSAHS) patients with macrophage migration inhibitory factor before and after operation (MIF) and soluble CD40 ligand (sCD40L) levels were detected, and to investigate the correlation between MIF and sCD40L patients, and to investigate the correlation between MIF and sCD40L in the patient's body, to further understand the relationship between between oxidative stress and inflammatory responses in patients and the related inflammatory factors. To provide a new basis for the diagnosis and treatment of OSAHS.
Method
Will have been monitored by PSG for diagnosis of severe OSAHS and 29 patients for the experimental group, 29 healthy men were selected as control group. Enzyme linked immunosorbent assay (ELISA) on serum macrophage migration inhibitory factor (MIF) were detected and the level of sCD40L, OSAHS group received uvulopalatopharyngoplasty, lift the respiratory tract obstruction, 6 months after the operation of OSAHS patients PSG. and review of serum macrophage migration inhibitory factor (MIF) and sCD40L. statistical analysis of the results was performed before and after surgery, observation of serum in patients with giant cell migration inhibitory factor (MIF) and sCD40L levels in serum, understand the mobile giant cell in experimental group and control (inhibitory factor MIF) difference and the level of sCD40L, PSG and changes of each index of observation.
Result
1. changes of every index of PSG before and after operation
Comparison of main indexes of PSG monitoring OSAHS patients before and after surgery, the measured values are expressed by X + s, data application group paired t test was used for statistical analysis, found that postoperative oxygen saturation increased (65.58 preoperative and postoperative 84.55 + 11.35, + 4.33) (P0.000), respiratory disturbance index (AHI) decreased (preoperative postoperative 59.74 + 17.74, 20.97 + 9.94) (P0.000), there are significant differences.
2. changes of serum concentration of MIF in patients before and after operation
Group MIF (preoperative? Postoperative? Control group) level, the results were expressed as X + s, before and after surgery were compared using the paired t test, preoperative, postoperative compared with the control group using two sample t test with.OSAHS 6 months after surgery, serum MIF value decreased significantly (4.03 before operation after + 0.78ng/ml, 2.89 + 0.75ng/ml) (P0.000), preoperative group and control group (preoperative 4.03 + 0.78ng/ml, 2.33 + 0.56ng/ control group ml) (P0.000), the postoperative group and the control group (after 2.89 + 0.75ng/mll, 2.33 + 0.56ng/ control group ml) (P=0.003). Before the operation. The postoperative MIF concentration compared with the control group there were significant differences, after operation decreased significantly.
3. changes of serum sCD40L level in patients before and after operation
Group sCD40L (preoperative? Postoperative? Control group) level, the results of X + s, preoperative, postoperative were compared using the paired t test, preoperative, postoperative compared with the control group using two sample t test.OSAHS patients after 6 months of serum sCD40L values were significantly decreased (before operation 6.68 + 1.63ng/ml, 4.50 + 1.10) after ng/ml (P0.000), preoperative group and control group (preoperative control group 6.68 + 1.63ng/ml, 3.11 + 0.69ng/ml) (P0.000), the postoperative group and the control group (after 4.50 + 1.10 ng/ml, control group 3.11 + 0.69ng/ml) (P0.05) before operation. After the operation, the concentration of sCD40L compared with the control group there were significant differences, after operation decreased significantly.
conclusion
The concentrations of 1. MIF and sCD40L in the sera of severe OSAHS patients were increased.
There was a significant decrease in MIF and sCD40L at 6 months after 2..
There is a positive correlation between serum MIF and sCD40L in patients with 3.OSAHS.
4. MIF and sCD40L can be used as an important indicator of the evaluation of the surgical efficacy of OSAHS patients.

【學(xué)位授予單位】：南華大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R766

【參考文獻(xiàn)】

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