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阻塞性睡眠呼吸暂停综合征患者甲状腺激素水平的变化
引用本文:李树奇,林其昌. 阻塞性睡眠呼吸暂停综合征患者甲状腺激素水平的变化[J]. 国际呼吸杂志, 2011, 31(13). DOI: 10.3760/cma.j.issn.1673-436X.2011.013.011
作者姓名:李树奇  林其昌
作者单位:1. 福建省宁德市医院呼吸内科(福建医科大学教学医院),352100
2. 福建医科大学附属第一医院呼吸内科,福州,350000
摘    要:目的 研究阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者甲状腺激素水平的变化,并进一步探讨慢性间断性缺氧在OSAHS患者甲状腺激素水平下降中的意义.方法 连续入选因打鼾在我院经多导睡眠仪行夜间7 h睡眠监测患者116例,夜间行多导睡眠呼吸监测,清晨抽取静脉血用放射免疫分析法检测血浆游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)和超级促甲状腺激素(sTSH)浓度,依据多导睡眠监测结果,并依据患者缺氧程度不同(即最低末梢血氧饱和度水平)分组:无明显缺氧组21例、轻度缺氧组43例、中度缺氧组30例和重度缺氧组22例.对比各实验组患者间FT3、FT4和sTSH浓度的差异.结果 ①伴随缺氧水平降低FT4浓度值逐渐降低且差异有统计学意义,两两比较各组间差异有统计学意义;②FT3、sTSH浓度值各组间差异无统计学意义,两两比较各组间差异亦无统计学意义.结论 缺氧越严重FT4水平越低,提示慢性间歇性缺氧可能是导致睡眠呼吸暂停患者甲状腺激素水平降低的重要因素.
Abstract:
Objective The purpose of this study was to investigate the change of plasma thyroxine (FT3,FT4,sTSH) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and probe into the action of chronic intermittent hypoxia in the change of thyroid hormone level. Methods Following 7hours' polysomnographic examination, 116 habitual snorers were selected and divided into 4 groups according to the diffences of minSpO2 :21 snores without anoxemia,43 snores with low-grade anoxemia,30snores with moderate anoxemia, 22 snores with severe anoxemia. Step 1, plasma concentrations of FT3,FT4 and sTSH were measured. Compare the difference of FT3, FT4, sTSH among different groups.Results In different anoxemia groups, the concentrations of FT4 were significant different, and the concentrations of FT4 were also significant different among the 4 groups by SNK method. The concentrations of FT3 and TSH were no different,after tested by SNK method, there was no significant difference between the groups too. Conclusions The FT4 levels decreased with the anoxemia. We can speculate chronic intermittent hypoxia was an important cause for the change of thyroxine level.

关 键 词:阻塞性睡眠呼吸暂停低通气综合征  甲状腺激素水平  慢性间歇性缺氧

Change of plasma thyroxine in patients with obstructive sleep apnea-hypopnea syndrome
LI Shu-qi,LIN Qi-chang. Change of plasma thyroxine in patients with obstructive sleep apnea-hypopnea syndrome[J]. International Journal of Respiration, 2011, 31(13). DOI: 10.3760/cma.j.issn.1673-436X.2011.013.011
Authors:LI Shu-qi  LIN Qi-chang
Abstract:Objective The purpose of this study was to investigate the change of plasma thyroxine (FT3,FT4,sTSH) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and probe into the action of chronic intermittent hypoxia in the change of thyroid hormone level. Methods Following 7hours' polysomnographic examination, 116 habitual snorers were selected and divided into 4 groups according to the diffences of minSpO2 :21 snores without anoxemia,43 snores with low-grade anoxemia,30snores with moderate anoxemia, 22 snores with severe anoxemia. Step 1, plasma concentrations of FT3,FT4 and sTSH were measured. Compare the difference of FT3, FT4, sTSH among different groups.Results In different anoxemia groups, the concentrations of FT4 were significant different, and the concentrations of FT4 were also significant different among the 4 groups by SNK method. The concentrations of FT3 and TSH were no different,after tested by SNK method, there was no significant difference between the groups too. Conclusions The FT4 levels decreased with the anoxemia. We can speculate chronic intermittent hypoxia was an important cause for the change of thyroxine level.
Keywords:Obstructive sleep apnea-hypopnea syndrome  Thyroxine  Chronic intermittent hypoxia
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