本文選題：睡眠呼吸暫停低通氣綜合征 + 基質(zhì)金屬蛋白酶P-9　； 參考：《南華大學》2010年碩士論文

【摘要】： 目的 對成人重度阻塞性睡眠呼吸暫停低通氣綜合征(OSAHS)患者治療前后基質(zhì)金屬蛋白酶p-9(MMP-9)和游離脂肪酸(FFA)水平變化進行跟蹤隨訪監(jiān)測,從而探討MMP-9及FFA與OSAHS患者呼吸紊亂指數(shù)、最低血氧飽和度及血脂相關(guān)性,為OSAHS病情程度及療效評估提供相關(guān)的依據(jù)。 方法 對38例擁有完整病例并符合納入條件的經(jīng)PSG監(jiān)測診斷為重度OSAHS患者,抽取清晨空腹血測試MMP-9、FFA、及臨床常規(guī)血脂四項(TG、TC、HDL、LDL)。對患者進行手術(shù)(H-UPPP術(shù))解除氣道阻塞,并于術(shù)前一周給予CPAP治療。對其治療前和治療后3個月相應(yīng)指標做出比較。將所得數(shù)據(jù)進行SPSS16.0統(tǒng)計學軟件處理分析并得出結(jié)論。 結(jié)果 1.OSAHS患者經(jīng)治療后:LSaO2明顯上升(P0.01),AHI明顯下降(P0.01),有統(tǒng)計學意義。 2.OSAHS患者經(jīng)治療后:血清MMP-9值、FFA值顯著下降(P0.01),有統(tǒng)計學意義。 3.OSAHS患者經(jīng)治療后:血脂四項中TG、TC、LDL值下降(P0.01),HDL值上升(P0.01),有統(tǒng)計學意義。 4 .MMP-9、FFA與AHI、LSaO2、TG、TC、HDL及LDL ,經(jīng)逐步回歸分析:AHI、LSaO2、TG與MMP-9、FFA關(guān)系最密切,對OSAHS患者體內(nèi)MMP-9、FFA影響最明顯( P0.01),有統(tǒng)計學意義。 5. MMP-9、FFA與AHI、LSaO2、TG、TC、HDL及LDL,經(jīng)相關(guān)分析:FFA與AHI、TG成正相關(guān)( P0.01),與LSaO2、HDL成負相關(guān)( P0.05),有統(tǒng)計學意義;MMP-9與AHI、TG成正相關(guān)( P0.01),與LSaO2成負相關(guān)( P0.01),有統(tǒng)計學意義。MMP-9和FFA與TC、LDL成正相關(guān)( P0.05),無統(tǒng)計學意義。 6.MMP-9與FFA經(jīng)直線回歸分析:MMP-9與FFA成正相關(guān)( P0.01),有統(tǒng)計學意義。 結(jié)論 1.有效的治療OSAHS,可以降低MMP-9與FFA的水平。 2. MMP-9和FFA可以作為評估OSAHS患者病情嚴重程度的重要指標之一。
[Abstract]:Purpose The changes of matrix metalloproteinase p-9 (MMP-9) and free fatty acid (FFA) levels in adult patients with severe obstructive sleep apnea hypopnea syndrome (OSAHS) before and after treatment were followed up, and the respiratory disturbance index of patients with MMP-9, FFA and OSAHS were investigated. The correlation between minimum oxygen saturation and blood lipids may provide relevant evidence for the evaluation of the severity and curative effect of OSAHS. Method A total of 38 patients with severe OSAHS diagnosed by PSG monitoring were selected for early morning fasting blood samples for testing MMP-9 FFAs, and four items of routine blood lipids, TGG TCC and HDLL, were collected from 38 patients who were diagnosed as severe OSAHS by PSG monitoring. The airway obstruction was relieved by H-UPPP and CPAP was given one week before operation. The corresponding indexes before treatment and 3 months after treatment were compared. The data are processed and analyzed by SPSS16.0 statistical software and the conclusion is drawn. Result After the treatment of 1.OSAHS patients, the ratio of w / L SaO2 increased significantly (P 0.01) and decreased significantly (P 0.01). After treatment, the serum MMP-9 value and FFA value of 2.OSAHS patients decreased significantly (P 0.01). After treatment, there was a significant difference between the four items of serum lipids, the decrease of TGG TCU LDL value and the increase of HDL value (P 0.01 and P 0.01) in the patients with 3.OSAHS. 4. MMP-9 FFA was most closely related to TGG and LDL by stepwise regression analysis, and had the most significant effect on MMP-9 FFA in patients with OSAHS (P0.01, P 0.01, P < 0.05). 5. MMP-9 FFA was positively correlated with AHI LSAO 2 TGG TCU HDL and LDL. The positive correlation was found between FFA and TG (P0.01), and negative correlation was found with LSaO2 HDL (P0.05). There was a significant positive correlation between MMP-9 and LSaO2 (P0.01, MMP-9, FFA and TCLDL) (P0.05P, no statistical significance). 6.MMP-9 and FFA were positively correlated with FFA by linear regression analysis (P 0.01). Conclusion 1. Effective treatment of OSAHS can reduce the levels of MMP-9 and FFA. 2. MMP-9 and FFA can be used as an important index to evaluate the severity of OSAHS.
【學位授予單位】：南華大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R766

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