阻塞性睡眠呼吸暂停低通气综合征患者呼出气中TNF—α水平的临床意义

目的：探讨呼出气冷凝液（exhaled breath condensate,EBC）中肿瘤坏死因子-α（tumor necrosis factor-α,TNF-α）与阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea-hyperpnoea syndrome,OSAHS）的关系以及持续气道正压（continuous positive airway pressure,CPAP）治疗对OSAHS患者EBC中TNF-α的影响。方法：将39例分为3组：健康志愿者组10例（AHI〈5）,轻度OSAHS患者组9例（520）。收集研究对象的EBC,用酶联免疫吸附试验（enzyme-linked immunosorbent assay,ELISA）检测EBC中TNF-α水平。收集9例中重度OSAHS患者经3个月CPAP治疗后的EBC,用ELISA法检测其中TNF-α水平并与治疗前比较。结果：健康志愿者组、轻度OSAHS患者组和中重度OSAHS患者组EBC中TNF-α浓度分别为：25.50±12.96pg.mL-1,33.77±18.00pg.mL-1,50.42±24.62pg.mL-1。健康志愿者组与中重度OSAHS患者组之间的差异有统计学意义（P〈0.01）。健康志愿者组与轻度OSAHS患者组、轻度OSAHS患者组与中重度OSAHS患者组之间的差异无统计学意义（P〉0.05）。9例中重度OSAHS患者CPAP治疗前后EBC中TNF-α浓度分别为50.42±24.62pg.mL^-1和29.50±25.20pg.mL^-1,差异有统计学意义（P〈0.05）。结论：中重度OSAHS患者EBC中TNF-α水平明显升高,经CPAP治疗后其水平降低。

Clinical Significance of the Level of TNF-α in Exhaled Breath Condensate of Patients with OSAHS

Objective：To study the relationship between the level of TNF-α in exhaled breath condensate（EBC） and obstructive sleep apnea-hyperpnoea syndrome （OSAHS）and the influence of continuous positive airway pressure （CPAP） on TNF-α level in EBC of OSAHS patients. Methods： A total of 39 subjects were enrolled and were divided into three groups, that was group of 10 healthy volunteers apnea-hypopnea index （AHI） 〈5], group of 9 patients with mild OSAHS （5 〈AHI 〈20） and group of 20 patients with moderate to severe OSAHS （AHI〉 20）. The EBC of all subjects were collected and the level of TNF-α were detected using ELISA. The EBC of 9 moderate to severe OSAHS patients who had underwent CPAP treatment for 3 months were collected and the level of TNF-α in these samples were detected using ELISA and then was compared with those before treatment . Results： TNF-α concentration in EBC of healthy volunteers group, mild OSAHS group and modcrate to severe OSAHS group were as follows： 25.50± 12.96 pg · mL^-1 , 33.77± 18.00 pg ·mL^-1 , 50.42± 24.62 pg ·mL^-1. The differences between healthy volunteers and moderate to severe OSAHS patient was statistically significant （P〈0. 01）, while the difference between healthy volunteers and mild OSAHS patients group and the difference between mild OSAHS patients and moderate to severe OSAHS patients were of no sense （P〉 0.05）. The TNF-α concentrations in EBC of 9 moderate or severe OSAHS patients before and after CPAP treatment were 50. 42 ± 24. 62 pg · mL^-1 and 29.50 ± 25.20 pg· mL^-1 , with the difference statistically significant （P〈0.05）. Conclusions： TNF-α level in EBC of patients with moderate and severe OSAHS were significantly elevated which can be reversed hy CPAP treatment.