OSAHS患者外周血肿瘤坏死因子-αmRNA表达及其蛋白水平的变化和意义

目的探讨肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）在阻塞性睡眠呼吸暂停-低通气综合征（obstructive sleep apnea-hypopnea syndrome，OSAHS）患者中的作用和临床意义。方法分别用RT-PCR方法分析患者组和对照组外周血单个核细胞（peripheral blood mononuclear cells，PBMCs）中TNF-α基因的表达及化学发光法检测血清中TNF-α水平。结果OSAHS组与对照组相比，中重度OSAHS患者组TNF．dmRNA表达较正常对照组高（42．75±20．00）％vs（28．16±12．49）％]（P〈0．05），轻度组与中重度组及正常对照组比较差异无统计学意义（P〉0．05）；各组间血清TNF-α水平差异无统计学意义（P〉0．05），但血清TNF-α水平与呼吸暂停低通气指数（apnea-hypopnea index，AHI）及氧减指数呈正相关（r分别为0．456、0．552，P均〈0．05），与夜间最低血氧饱和度呈负相关（r=-0．452，P〈0．05）。结论炎症因子TNF-α可能参与OSAHS的病理生理过程。

The Changes of mRNA Expression and Serum Levels of Tumor Necrosis Factor-α in the Peripheral Blood of Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

Objective To investigate the role and clinical significance of tumor necrosis factor-or （TNF-α） in patients with obstructive sleep apnea-hypopnea syndrome （OSAHS）. Method Expression of TNF-α mRNA in PBMCs was determined by RT-PCR and the level of serum TNF-α was measured by chemiluminescence. Result The expression of TNF-α mRNA in moderate to severe OSAHS patients （42.75±20） % was higher than the control subjects （28.16±12.49）%, P〈0.05. The level of serum TNF-α in OSAHS patients was not significantly different from the control subjects （P 〉0.05）. However, the level of serum TNF-α was positively correlated with AHI （r=0.456, P〈 0.05） and oxidative desaturation index （ODI,r=0.552, P〈0.05）, and negatively correlated with the minimal SPO2 （r=-0.452,P〈0.05）. Conclusion The level of pro-inflammatory cytokine TNF-α may be involved in the pathogenic development of cardiovascular diseases in patients with OSAHS.