摘要
目的探讨影响男性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清铁蛋白(SF)水平变化的相关因素。方法选择就诊于甘肃省人民医院睡眠医学中心(鼾病科)经多导睡眠仪(PSG)监测明确诊断为OSAHS的男性患者142例,平均年龄(46.0±11.0)岁;对照组选取同期PSG监测显示睡眠呼吸暂停低通气指数(AHI)<5次/h的非OSAHS男性50例,平均年龄(43.5±10.9)岁。以AHI为依据分为轻、中、重OSAHS 3个亚组。收集所有对象的一般临床资料,睡眠呼吸指标由PSG测得,酶联免疫吸附法测定SF水平。结果各组间年龄、体质量指数(BMI)、颈围、腰臀比(WHR)差异均无统计学意义;OSAHS组患者合并高血压病、2型糖尿病和脑白质病(LCPP)的比例高于正常组(χ2=4.286,3.904,4.664;P<0.05),但OSAHS各亚组及对照组间差异均无统计学意义(P>0.05)。SF水平与对照组(367.5±88.3)μg/L比较,轻度OSAHS组(290.0±113.3)μg/L、中度OSAHS组(320.2±143.5)μg/L,和重度OSAHS组(464.7±111.8)μg/L显著增高,且OSAHS 3组间SF水平差异均有统计学意义(F=33.78,P<0.01),即OSAHS病情越重,SF水平越高。Pearson相关性分析显示AHI(r=0.837,P<0.01)、氧减指数(SaO2DI)(r=-0.853,P<0.01)、夜间SaO2低于90%的时间占总睡眠时间的百分比(SLT90)(r=0.408,P<0.01)和微觉醒指数(MAI)(r=0.964,P<0.01)与SF呈正相关;最低血氧饱和度(SaO2min)(r=-0.789,P<0.01)和N3期比例(N3%)(r=-0.864,P<0.05)与SF水平呈负相关。结论男性OSAHS患者SF水平显著升高,AHI、SaO2DI、SLT90、MAI、SaO2min和N%与SF可能是影响其水平变化的相关因素;推测其可能通过炎症机制在男性OSAHS患者并发高血压、2型糖尿病和LCPP的合并症中发挥作用。
Objective To evaluate serum ferritin （SF）level in male patients with obstructive sleep apnea-hypopnea syndrome （OSAHS ） and related factors. Methods 142 male patients with OSAHS diagnosed by polysomnography（PSG）were selected from Gansu Provincial Hospital.The patients were divided into mild,moderate and severe groups according to aponea-hypopnea index （AHI）,mean age （46.0＆#177;1 1.0）years old,50 cases diagnosed by PSG（AHI）〈5 times/h were enrolled as control group,the mean age （43.5＆#177;10.9）years old.Their general clinical materials were collected and the patients monitored by PSG,SF was determined by ELISA.The gender,age,BMI, waist hip ratio （WHR） and neck circumstance had no significant difference among four groups. Results The proportion of OSAHS patients with hypertension（HT）,T2DM and leukoencephalopathy （LCPP）were higher than those of control group（P 〈0.05,respectively）.However,there were no significant difference among three OSAHS subgroups（P 〉 0.05 ）.The SF in mild,moderate and severe group were respectively higher than those of control group （P 〈 0.01 ）.SF was significantly increased according to OSAHS severity （P 〈 0.01 ）.Pearson analysis indicated SF correlated positive with AHI（r =0.837,P 〈0.01）,SaO 2 DI（r =-0.853,P 〈0.01）,SLT90% （r =0.408,P 〈0.01）,MAI（r =0.964,P 〈0.01）,but negative with SaO 2 min（r =-0.789,P 〈0.01）and N3 stage proportion（N3%）（r =-0.864,P 〈0.05）.Conclusion SF significantly increased in male patients with OSAHS and might correlate with AHI,SaO 2 DI,SLT90,MAI and SaO 2 min.High SF may play an important role in male OSAHS patients with HT,T2DM and LCPP by inflammatory mechanism.
出处
《临床荟萃》
CAS
2015年第9期1039-1042,1046,共5页
Clinical Focus
基金
甘肃省科学技术研究与开发专项计划(130TCYA031)
