阻塞性睡眠呼吸暂停低通气综合征患者血清瘦素及瘦素受体水平的变化

目的探讨血清瘦素（leptin）及瘦素受体（leptin R）水平在不同严重程度及肥胖程度的阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者中的变化。方法应用酶联免疫吸附法（ELISA）测定71例OSAHS患者和14名正常对照者血清leptin及leptin R水平,同时计算体质量指数（BMI）、监测呼吸暂停低通气指数（AHI）等指标。结果 （1）AHI与BMI成显著正相关（r=0.4711,P〈0.01）。（2）AHI≤20次/h组中,肥胖组leptin R水平明显高于非肥胖组（P〈0.05）,leptin水平的差异无统计学意义（P〉0.05）;AHI〉20次/h组中,肥胖组的leptin水平明显高于非肥胖组（P〈0.01）,leptin R水平的差异无统计学意义（P〉0.05）。结论 OSAHS与肥胖关系密切。中、重度肥胖OSAHS患者leptin R水平不再明显升高,提示leptin-leptin R调节系统已基本失去调节代偿作用,必须予以积极治疗以改善预后。

The Change of Levels of Serum Leptin and Leptin R in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

Objective To explore the serum levels of leptin and leptin R in different degrees of obesity and obstructive sleep apnea-hypopnea syndrome（OSAHS）.Methods The expressions of leptin and leptin R were detected by immunohistochemical method in 71 patients and 14 controls.Body mass index（BMI） and apnea-hypopnea index（AHI） were calculated and monitored.Results（1） The AHI had a significant positive correlation with BMI（r = 0.471 1,P〈0.01）.（2） In the subjects with low AHI（AHI≤ 20 /h）,the serum level of leptin R was significantly higher in obesities compared with non-obesities（P 〉0.05）,but there was no significant difference in serum level of leptin（P 〉0.05） ;In patients with high AHI（AHI 20/h）,the serum level of leptin was significantly higher in obese patients compared with non-obesities（P〈0.01）,but no significant difference was found in serum level of leptin R（P〉 0.05）.Conclusion OSAHS is closely related with obesity.In the moderate-to-severe obese OSAHS patients,the level of leptin R is no longer increased evidently,indicating that the leptin-leptin R regulatory system has lost the function of regulation and compensation.It requires positive treatment to improve prognosis.