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目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆TNF-α水平的变化,以及CPAP治疗的影响和临床意义。方法:48例多导睡眠图确诊的男性OSAHS患者,按照呼吸暂停低通气指数(AHI)分为轻度OSAHS组(n=15),中度OSAHS组(n=16),重度OSAHS组(n=17)。16例年龄和体重指数(BMI)匹配的健康男性作为对照组,其中13例中重度OSAHS患者进行持续气道正压通气(CPAP)治疗。ELISA法测定血浆TNF-α浓度。对OSAHS患者血浆TNF-α与睡眠期AHI和最低脉氧饱和度(miniSpO2)进行Pearson相关性分析。结果:轻度、中度和重度OSAHS组TNF-α浓度分别为(11.49±1.32pg/ml)、(13.29±1.73pg/ml)、(14.74±2.72pg/ml),均显著高于正常对照组(9.29±1.74pg/ml)。TNF-α水平随OSAHS程度加重而增高。Pearson相关性分析显示OSAHS患者TNF-α浓度与呼吸暂停低通气指数(AHI)呈显著正相关(r=0.714,P<0.001),与miniSpO2间呈显著负相关(r=-0.601,P<0.001)。CPAP治疗后OSAHS患者血浆TNF-α水平显著降低(P<0.001)。结论:CPAP治疗可降低或防止OSAHS患者的动脉硬化进展。
Objective: To investigate the changes of plasma TNF-α levels in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and the impact and clinical significance of CPAP treatment. Methods: Forty male patients with OSAHS confirmed by polysomnography were divided into mild OSAHS group (n = 15), moderate OSAHS group (n = 16) and severe OSAHS group (n OSAHS group) according to apnea hypopnea index = 17). Sixteen healthy men with matched age and body mass index (BMI) served as control group. Thirteen patients with moderate-to-severe OSAHS underwent continuous positive airway pressure (CPAP). ELISA method for the determination of plasma TNF-α concentration. Pearson correlation analysis was performed on plasma TNF-α, sleep AHI and miniSpO2 in patients with OSAHS. Results: The concentrations of TNF-α in OSAHS group were (11.49 ± 1.32pg / ml), (13.29 ± 1.73pg / ml) and (14.74 ± 2.72pg / ml) respectively, which were significantly higher than those in normal control Group (9.29 ± 1.74 pg / ml). TNF-α levels increased with the degree of OSAHS increased. Pearson correlation analysis showed that there was a significant positive correlation between TNF-α concentration and apnea-hypopnea index (AHI) in OSAHS patients (r = 0.714, P <0.001) and negative correlation with miniSpO2 ). The levels of plasma TNF-α in patients with OSAHS after CPAP treatment were significantly lower (P <0.001). Conclusion: CPAP treatment can reduce or prevent the progression of atherosclerosis in OSAHS patients.