阻塞性睡眠呼吸暂停低通气综合征患者体内氧化应激状态分析

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者体内氧化应激状态。方法OSAHS轻、中、重组共70例,对照组25例进行多导睡眠仪监测(PSG);采集受试者当天睡前及次日晨起空腹静脉血,OSAHS重度组尚需采集nCPAP治疗1个月后清晨空腹静脉血,检测血清中丙二醛(MDA)、谷胱甘肽(GSH)含量。结果OSAHS各组与对照组晨起血清MDA含量及晨起血清GSH含量比较差异有统计学意义(P均<0.05);进一步分析OSAHS组血清MDA与GSH含量呈负相关(r=-0.81,P<0.05),晨起血清MDA与患者睡眠呼吸暂停低通气指数(AHI)呈正相关(r=0.657,P<0.05),与最低SpO2、平均SpO2呈负相关(r分别为-0.576、-0.682,P均<0.05),晨起血清GSH与患者AHI呈负相关(r=-0.583,P<0.05),与最低SpO2、平均SpO2呈正相关(r分别为0.657、0.683,P均<0.05);OSAHS各组睡前血清MDA含量较晨起降低,但仍高于对照组,OSAHS各组睡前血清GSH含量较晨起升高,但仍低于对照组,差异有统计学意义(P均<0.05);经nCPAP治疗后重度组患者晨起血清MDA含量降低,晨起血清GSH含量升高,与对照组比较差异无统计学意义(P均>0.05)。结论OSAHA患者体内存在持续氧化应激状态,随着病情严重程度而加重;经nCPAP治疗4周后,氧化应激状态可恢复正常水平。

Change of oxidative stress in patients with obstructive sleep apnea-hypopnea syndrome

Objective To investigate the change of oxidative stress in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods 70 patients with OSAHS and 25 cases without OSAHS proved by polysomnography(PSG) were selected as observation and control group respectively. The serum was collected before and after sleep at the same night from both groups. In addition, the serum was also collected from the severe OSAHS group after 4 weeks of nCPAP treatment. The levels of serum malonyl dialdegyde(MDA) and glutathione peroxidase(GSH) were measured. Results The serum levels of MDA were significantly higher in OSAHS group than those in control group(P<0.05).The serum levels of GSH were significantly lower in OSAHS group than those in control group(P<0.05),and there was a negative correlation between MDA level and GSH in patients with OSAHS(P<0.05).Also, there was a positive correlation between MDA level and AHI(r=0.657,P<0.05) and a negative correlation between MDA level and lowest saturation of blood oxygen as well as average saturation of blood oxygen(P<0.05). There was a negative correlation between GSH level and AHI(P<0.05) and a positive correlation between GSH level and lowest saturation of blood oxygen as well as average saturation of blood oxygen(P<0.05).There was a significant difference between morning and night level as far as MDA and GSH was concerned in OSAHS group(P<0.05),but still there was a significant difference between the OSAHS group and control group(P<0.05).After 4 weeks of nCPAP treatment, the serum levels of MDA were shown decreased and the serum levels of GSH were shown increased. There was no significant difference between the severe OSAHS group and control group(P>0.05). Conclusion Continuous oxidative stress is a characteristic change in OSAHS and become severe along with the developmeng of the illness.After 4 weeks of nCPAP treatment, the level of oxidative stress become normal.