阻塞性睡眠呼吸暂停低通气综合征患者血清肿瘤坏死因子-α、白细胞介素-6水平的检测及临床意义

目的初步探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）水平的变化及临床意义,并揭示其与OSAHS相关心脑血管病可能存在的相关性。方法 （1）收集单纯鼾症30例、OSAHS患者轻度45例、中度65例、重度68例,采用酶联免疫吸附法（ELISA）检测血清TNF-αI、L-6水平,行相关分析,并计算各组心脑血管病患病率。（2）对接受/未接受经鼻持续气道正压通气（nC-PAP）治疗的中重度OSAHS者随访2月,观察有效nCPAP治疗后TNF-αI、L-6水平的变化。结果 （1）血清TNF-αI、L-6水平随OSAHS病情加重而升高,以重度OSAHS组最高。血清TNF-αI、L-6水平与AHI、tSpO2〈90%呈正相关,与MeanSpO2、MinSpO2呈负相关。随OSAHS病情加重,心脑血管病患病率逐渐增加。（2）中重度OS-AHS患者接受有效nCPAP治疗2月后血清TNF-α及IL-6水平下降;而未接受nCPAP治疗者未发现类似变化。结论 OSAHS患者血清TNF-αI、L-6水平以及心脑血管病患病率均明显升高,提示TNF-αI、L-6水平可能与OSAHS相关心脑血管病发生有关;有效nCPAP治疗可使TNF-αI、L-6水平下降,可能最终减少相关心脑血管病的发生。

Detection and Clinical Significance of Serum TNF-α,IL-6 Levels in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

Objective To observe the changes of serum TNF-α,IL-6 Levels in patients with obstructive sleep apnea-hypopnea syndrome（OSAHS） and investigate their clinical significance in the occurrence of OSAHS-related cardiocerebral vascular diseases.Methods Following polysomnographic examination,208 adult male patients were divided into 4 groups： 30 with simple snorers,45 with mild OSAHS,65 with moderate OSAHS,and 68 with severe OSAHS.The serum levels of TNF-α and IL-6 of all the patients were determined by enzyme linked immunosorbent assay（ELISA）;the correlations between TNF-α（or IL-6）and other factors were analyzed;the incidence of cardiocerebral vascular diseases for each group was calculated.Patients with moderate or severe OSAHS were divided into 2 groups： nasal-continuous positive airway pressure（nCPAP） group and control group,and received further follow-up.After 2 months＇ follow-up,their serum levels of TNF-α and IL-6 were determined.Results Serum levels of TNF-α and IL-6 both increased with exacerbation of OSAHS,which was most significant in patients with severe OSAHS.Serum TNF-α and IL-6 Levels were correlated positively with AHI and tSpO290%,and negatively with MeanSpO2 and MinSpO2.The incidence of cardiocerebral vascular diseases increased with OSAHS Exacerbation.After 2 months＇ follow-up,there was a significant decrease in serum levels of TNF-α and IL-6 in nCPAP group while there were no similar changes in the control group.Conclusion Serum levels of TNF-α and IL-6 and the incidence of cardiocerebral vascular diseases are significantly increased in OSAHS patients.Increased serum levels of TNF-α and IL-6 may lead to the associated cardiocerebral vascular diseases.Effective nCPAP therapy may help decrease serum levels of TNF-α and IL-6 and reduce the associated cardiocerebral vascular diseases in OSAHS patients.