【摘要】：目的：通過定量測定阻塞性睡眠呼吸暫停低通氣綜合征(obstructive sleep apnea-hypopnea syndrome, OSAHS)患者血清中腫瘤壞死因子-α (TNF-α)、鐵調(diào)素(hep)含量,探討兩者在OSAHS患者中的表達(dá),闡明它們在OSAHS發(fā)病過程中的作用。 方法：本研究隨機(jī)選取了2012年3月-2014年3月昆明醫(yī)學(xué)院第二附屬醫(yī)院及云南省第一人民醫(yī)院確診為OSAHS患者共計(jì)95例(其中輕度24例,中度27例,重度44例),無打鼾的健康人30例作為正常對照組,測定各組血清TNF-α、鐵調(diào)素的水平。并同時(shí)檢測各組OSAHS患者睡眠暫停低通氣指數(shù)(AHI)、最低血氧飽和度(Sp02)兩項(xiàng)呼吸睡眠檢測指標(biāo)。將所有數(shù)據(jù)用SPSS13.5統(tǒng)計(jì)軟件進(jìn)行處理分析。 結(jié)果： 1、OSAHS各組與正常對照組在年齡、體重、體重指數(shù)(Body mass index,BMI)比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。 2、TNF-α在OSAHS患者血清中輕度組含量為17.52±2.20pg/ml、中度組為25.05±3.89pg/ml、重度組為43.29±12.95pg/ml,均高于正常對照組11.03±4.22pg/ml,差異均有統(tǒng)計(jì)學(xué)意義(p0.01),且OSAHS病情程度越嚴(yán)重,TNF-α含量越高。 3、鐵調(diào)素在OSAHS患者血清中輕度組含量為585.51±111.99pg/ml、中度組為949.24±168.45pg/ml、重度組為1890.95±495.54pg/ml的水平均高于正常對照組375.70±91.47pg/ml,差異均有統(tǒng)計(jì)學(xué)意義(p0.01),且OSAHS病情程度越嚴(yán)重,鐵調(diào)素含量越高。 4、OSAHS組血清TNF-α、鐵調(diào)素呈顯著正相關(guān)。(r=0.728,p0.01) 5、OSAHS組血清TNF-α、鐵調(diào)素的水平與睡眠呼吸暫停低通氣指數(shù)(AHI)呈顯著正相關(guān)。(r=0.723,r=0.862,p0.01) 6、OSAHS組血清TNF-α、鐵調(diào)素的水平與睡眠監(jiān)測中的最低SPO2呈顯著負(fù)相關(guān)。(r=-0.641,r=-0.647,p0.01 結(jié)論： 1、OSAHS組中血清TNF-a、鐵調(diào)素表達(dá)水平較正常對照組血清中顯著增高,顯示血清TNF-α、鐵調(diào)素的異常表達(dá)與OSAHS患者的病情有關(guān)。 2、血清TNF-α、鐵調(diào)素與OSAHS各組之間比較顯示存在差異,顯示OSAHS病情越嚴(yán)重,兩者的表達(dá)水平越高。 3、OSAHS組血清TNF-a、鐵調(diào)素的表達(dá)與睡眠呼吸暫停低通氣指數(shù)呈顯著正相關(guān),與睡眠監(jiān)測最低SpO2呈顯著負(fù)相關(guān),說明兩者與OSAHS病情程度相關(guān)。 4、血清TNF-α、鐵調(diào)素可以作為OSAHS嚴(yán)重程度的生物學(xué)指標(biāo)。
[Abstract]:Objective: to investigate the expression of tumor necrosis factor- 偽 (TNF- 偽) and iron modulin (hep) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) by quantitative determination of serum tumor necrosis factor- 偽 (TNF- 偽) and iron modulin (hep) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). To elucidate their role in the pathogenesis of OSAHS. Methods: from March 2012 to March 2014, 95 patients with OSAHS were randomly selected from the second affiliated Hospital of Kunming Medical College and the first people's Hospital of Yunnan Province (including 24 mild cases, 27 moderate cases, 44 severe cases). The serum levels of TNF- 偽 and iron modulin were measured in 30 healthy subjects without snoring as normal control group. Sleep apnea hypopnea index (AHI),) minimum oxygen saturation (Sp02) was measured in all OSAHS patients. All the data are processed and analyzed by SPSS13.5 statistical software. Results: 1 there was no significant difference in age and body mass index (Body mass index,BMI) between OSAHS group and normal control group (P0.05). 2the serum TNF- 偽 levels in OSAHS patients were 17.52 鹵2.20pg / ml, 25.05 鹵3.89pg / ml, 43.29 鹵12.95pg / ml in mild group, 25.05 鹵3.89pg / ml in moderate group and 43.29 鹵12.95pg / ml in severe group, which were higher than that in normal control group (11.03 鹵4.22pg / ml). The difference was statistically significant (p 0.01), and the more severe the OSAHS, the higher the content of TNF- 偽. 3. The serum levels of iron modulin in OSAHS patients were 585.51 鹵111.99pg / ml, 949.24 鹵168.45pg / ml, 1890.95 鹵495.54pg/ml, respectively, which were significantly higher than those in normal controls (375.70 鹵91.47pg / ml). The difference was statistically significant (p0.01), and the more severe the OSAHS, the higher the iron content. (4) there was a significant positive correlation between serum TNF- 偽 and iron modulin in OSAHS group. (r = 0.728, p 0.01). There was a significant positive correlation between serum TNF- 偽 and (AHI) of sleep apnea hypopnea index (r = 0.723, P < 0.05). The levels of serum TNF- 偽 and iron modulin were negatively correlated with the lowest SPO2 in sleep monitoring. Conclusion: 1 the serum TNF-a, in OSAHS group was negatively correlated with the lowest SPO2 in sleep monitoring. (conclusion: 1) in the OSAHS group, the levels of serum TNF- 偽 and iron modulin were negatively correlated with the lowest SPO2 in sleep monitoring. (conclusion: 1) the level of serum TNF-a, in OSAHS group was negatively correlated with the lowest SPO2 in sleep monitoring. The level of iron modulin expression in serum was significantly higher than that in the normal control group, indicating that the abnormal expression of TNF- 偽 and iron modulin in serum was related to the condition of OSAHS patients. 2. The comparison of serum TNF- 偽, iron modulin and OSAHS showed that the more serious the condition of OSAHS, the higher the expression level of OSAHS. 3There was a significant positive correlation between the expression of serum TNF-a, iron and sleep apnea hypopnea index in OSAHS group, and a significant negative correlation with the lowest SpO2 in sleep monitoring, which indicated that the expression of irontin in serum was correlated with the severity of OSAHS. 4. Serum TNF- 偽 and iron modulin can be used as a biological index of OSAHS severity.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R766

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