阻塞性睡眠呼吸暂停低通气综合征患者血清瘦素水平的研究

目的 探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者血清瘦素水平以及口腔矫治器治疗对患者血清瘦素水平的影响。方法 对22例经过多导睡眠监测确诊的OSAHS患者行口腔矫治器治疗。采用放射免疫测定法测定22例OSAHS患者治疗前、治疗后以及22例年龄、体质指数相近的单纯打鼾患者（对照组）的血清瘦素水平，分析瘦素与呼吸暂停低通气指数（AHI）、体质指数的关系，以及治疗前、治疗后血清瘦素水平的变化。结果 OSAHS患者血清瘦素水平与AHI呈正相关（r=0．469，P〈0．05），与夜间最低动脉血氧饱和度呈负相关（r=-0．787，P〈0．01）。治疗前OSAHS患者的血清瘦素水平明显高于对照组。口腔矫治器治疗后患者AHI及最低血氧饱和度明显改善，且血清瘦素水平较治疗前明显降低。结论 OSAHS患者血清瘦素水平增高，且瘦素水平与睡眠呼吸暂停的程度有密切联系；口腔矫治器治疗有效者血清瘦素水平下降。呼吸暂停有可能是导致OSAHS患者体内瘦素水平增高的重要因素。

Serum leptin levels in patients with obstructive sleep apnea-hypopnea syndrome

Objective To investigate the effect of dental appliances on serum leptin levels in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods Twenty-two patients with OSAHS diagnosed by polysomnography were treated with dental appliances.Pretreatment and posttreatment serum leptin concentrations in 22 patients with OSAHS and in 22 age- and BMI-matched controls were measured by radioimmunoassay.Correlations between leptin concentrations and apnea-hypopnea index(AHI) as well as BMI were analyzed.Results The leptin concentration of OSAHS patients was positively correlated with AHI(r=0.469,P<0.05) and negatively correlated with nocturnal minimum arterial oxygen saturation(r=-0.787,P<0.01).The concentrations of leptin in patients with OSAHS were higher than those in controls before treatment(P<0.01).After treatment,AHI and minimum arterial oxygen saturation were significantly improved and the leptin level was obviously decreased.Conclusion The leptin concentrations in patients with OSAHS are increased,which are significantly correlated with the severity of disease.Serum leptin levels in responders are decreased significantly after the treatment by dental appliances.