發(fā)布時(shí)間：2018-06-08 00:19

  本文選題：阻塞性睡眠呼吸暫停 + 抑郁��； 參考：《山西醫(yī)科大學(xué)》2011年碩士論文

【摘要】：目的:擬通過分析OSA患者一般特征、臨床指標(biāo)與抑郁評分的關(guān)系,尋找OSA合并抑郁的相關(guān)因素并探討IL-18在其表達(dá)過程中的意義。 方法:根據(jù)睡眠呼吸監(jiān)測(PSG)與抑郁評分(SDS評分)結(jié)果,將所有觀察對象為正常組、單純OSA組、OSA合并抑郁組、單純抑郁組。采集性別、年齡、文化程度、吸煙史、飲酒史、病程等一般特征及BMI(身高、體重)、ESS(用Epworth嗜睡量表評定患者嗜睡情況)、合并癥(如高血壓、糖尿病、心血管疾病)和PSG監(jiān)測指標(biāo)(AHI、最低血氧飽和度)并進(jìn)行分層。整夜多導(dǎo)睡眠監(jiān)測后晨起抽取患者靜脈血分離血清做標(biāo)本,采用酶聯(lián)免疫吸附測定法(ELISA)檢測IL-18、5-HT的含量。用單因素方差分析(四組比較)、LSD-t檢驗(yàn)(組間兩兩比較)、卡方檢驗(yàn)、pearson相關(guān)、多重線性回歸進(jìn)行數(shù)據(jù)處理。 結(jié)果:(1)OSA患者中抑郁的患病率為49.06%,根據(jù)年齡、受教育程度和病程及最低SaO2、BMI、ESS和有無并發(fā)癥的不同,OSA患者的抑郁患病率差異有顯著性(P0.01),而不同性別、是否吸煙和飲酒及不同的AHI對OSA患者抑郁的患病率沒有明顯的影響(P0.05)。(2)單純抑郁組IL-18的水平較正常組高(P0.05);所有OSA患者IL-18明顯較正常人群高(P0.05),而且OSA合并抑郁的患者較單純OSA患者進(jìn)一步增高,差異具有顯著性(P0.05),正常組、單純OSA組、OSA合并抑郁組分別為146.41±56.37,265.85±128.95,387.33±106.10。(3)單純抑郁組5-HT的水平較正常組高(P0.05);所有OSA患者中5-HT的水平較正常組高,OSA合并抑郁組升高更為明顯,差異具有顯著性(P0.05)、正常組、單純OSA組、OSA合并抑郁組分別為43.50±20.74,65.76±51.10,102.96±54.48。(4)多重線性回歸顯示:并發(fā)癥、BMI及最低SaO2可以解釋OSA患者中血清IL-18的變化情況;BMI、ESS及并發(fā)癥可以解釋OSA合并抑郁患者的SDS評分情況。(5)OSA合并抑郁患者血中IL-18與5-HT的水平呈正相關(guān)(r=0.59,P0.02)。 結(jié)論:1 OSA患者中抑郁的患病率為49.06%,OSA患者合并并發(fā)癥(高血壓、糖尿病、心血管病)、伴有嚴(yán)重的最低氧飽和度及中重度嗜睡和肥胖時(shí)抑郁的患病率會增加。2 OSA患者中IL-18的含量受并發(fā)癥、肥胖及最低SaO_2的影響。3 OSA合并抑郁患者SDS評分受肥胖、嗜睡程度及并發(fā)癥的影響。4 IL-18可能在OSA合并抑郁的發(fā)病機(jī)制中起一定的作用。
[Abstract]:Objective: to analyze the relationship between general characteristics, clinical indexes and depression scores of OSA patients. Methods: according to the results of sleep apnea monitoring (PSG) and depression score (SDS), all the subjects were divided into normal group and OSA group with depression. Simple depression group. Sex, age, education, smoking history, drinking history, course of disease, and BMI (height, weight) were measured by Epworth somnolence scale (Epworth somnolence scale), complications (such as hypertension, diabetes, etc.) Cardiovascular disease) and PSG monitoring index AHI, the lowest oxygen saturation) and stratification. Serum samples were collected from patients with polysomnography after overnight polysomnography, and the contents of IL-185-HT were detected by enzyme linked immunosorbent assay (Elisa). Univariate analysis of variance (four groups were compared with LSD-t test, chi-square test Pearson correlation, multiple linear regression) data processing. Results the prevalence of depression in patients with OSA was 49.06, according to age. There were significant differences in the prevalence of depression among the patients with education, course of disease, minimum SAO2 BMIESS and OSA with or without complications (P 0.01). There was no significant effect of smoking and drinking and different AHI on the prevalence of depression in OSA patients. (P0.05N. 2) the level of IL-18 in simple depression group was higher than that in normal group, and IL-18 level in all OSA patients was significantly higher than that in normal group, and OSA patients with depression were significantly higher than those in OSA patients with depression. Compared with simple OSA patients, The level of 5-HT in simple depression group was significantly higher than that in normal group (146.41 鹵56.37265.85 鹵128.95387.33 鹵106.10.3), the level of 5-HT in all OSA patients was higher than that in normal group. The difference was significant (P 0.05). Multiple linear regression analysis showed that BMIESS and complications could explain the changes of serum IL-18 in OSA patients with depression and BMIESS and the complications could explain the SDS score of OSA patients with depression. There was a positive correlation between serum IL-18 and 5-HT levels in patients with depression. Conclusion the prevalence rate of depression in patients with OSA is 49.06. The prevalence of depression in diabetes mellitus, cardiovascular disease, severe oxygen saturation and moderate and severe somnolence and obesity increased the level of IL-18 in the patients with OSA by complications, and the effects of obesity and the lowest SaO-2 on SDS score of patients with depression. 3 the SDS score of patients with depression was obese. The effects of somnolence and complications on IL-18 may play a role in the pathogenesis of OSA with depression.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R766

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本文編號：1993480