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探讨缺血修饰白蛋白(IMA)及C-反应蛋白(CRP)在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)诊断、病情评估以及疗效评价中的意义。研究选取2016年1月至10月该院呼吸科收治的OSAHS患者97例,根据多导睡眠监测(PSG)结果分为轻度OSAHS组46例,中度OSAHS组31例以及重度OSAHS组20例,同时选取30例单纯打鼾者作为对照组。分别于治疗前以及连续气道正压通气(CPAP)治疗一个月后检测所有患者的血清IMA和CRP水平。结果表明:OSAHS组血清IMA和CRP浓度显著高于对照组(P<0.05),且OSAHS组血清IMA浓度与OSAHS病情程度显著相关(P<0.05),而与年龄、性别及BMI无关。经1个月的CPAP治疗后OSAHS组血清IMA和CRP显著下降(P<0.05)。以66.5 U/L为临界值,血清IMA用于诊断OSAHS的敏感性为82.5%,特异性为86.7%,阳性预测值为95.2%,阴性预测值为60.5%。研究提示:血清IMA作为OSAHS的独立预测因素其水平和OSAHS的严重程度密切相关,对OSAHS的诊断、病情分析及疗效评价有一定临床意义;另外,OSAHS患者CRP显著增高,提示炎症反应可能参与了OSAHS的病理发展过程。
(IMA) and C-reactive protein (CRP) in diagnosis of obstructive sleep apnea-hypopnea syndrome (OSAHS), evaluation of the condition and evaluation of the curative effect. Ninety-seven OSAHS patients admitted to Department of Respiratory Medicine from Jan. to Oct. 2016 were selected and divided into four groups: mild OSAHS group (n = 46), moderate OSAHS group (n = 31) and severe OSAHS group (n = 20) according to polysomnography (PSG) At the same time, 30 simple snorers were selected as the control group. Serum levels of IMA and CRP were measured in all patients before treatment and one month after continuous positive airway pressure (CPAP) treatment. The results showed that serum IMA and CRP concentrations in OSAHS group were significantly higher than those in control group (P <0.05), and serum IMA concentration in OSAHS group was significantly correlated with OSAHS severity (P <0.05), but not with age, sex and BMI. Serum IMA and CRP in OSAHS group decreased significantly (P <0.05) after 1 month CPAP treatment. With 66.5 U / L as the critical value, serum IMA was used to diagnose OSAHS with a sensitivity of 82.5%, a specificity of 86.7%, a positive predictive value of 95.2% and a negative predictive value of 60.5%. The study suggests that serum IMA as an independent predictor of OSAHS is closely related to the severity of OSAHS and has clinical significance for the diagnosis, assessment of disease and evaluation of the therapeutic effect of OSAHS. In addition, CRP is significantly increased in patients with OSAHS, suggesting that inflammation may be involved OSAHS pathological development process.