重度OSAHS患者UPPP手术前后血清CRP的检测及意义

目的探讨重度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者经等离子辅助改良悬雍垂腭咽成形术（UPPP）治疗前后血清C反应蛋白（CRP）的变化和意义。方法应用免疫比浊法测定阻塞平面为口咽平面狭窄的30例重度OSAHS患者经术前持续正压通气治疗（CPAP）前后、低温等离子辅助改良悬雍垂腭咽成形术（UPPP）术后1周、3月及6月血清中CRP水平,同时检测10例健康体检志愿者血清中的CRP水平。结果重度OSAHS组血清CRP（8.61±0.23 mg/L）,健康对照组血清CRP（2.86±0.34 mg/L）;重度OSAHS组CRP水平明显高于对照组（P〈0.01）,OSAHS患者经CPAP治疗1周后血清CRP（4.88±0.32 mg/L）,CRP水平低于治疗前（P〈0.05）;UPPP术后1周、3个月、6个月血清CRP水平分别为（7.78±0.4 mg/L,3.12±0.28 mg/L,3.46±0.82 mg/L）;UPPP术后1周、3个月、6个月PSG监测AHI分别为（24.5±13.2次/h,4.5±3.1次/h,5.2±1.6次/h）、最低血氧饱和度（Sa O2）分别为（80.2±4.8）%、（90.3±3.1）%、（89.6±3.2）%。结论重度OSAHS患者术前CPAP治疗可降低血清CRP水平,提高UPPP手术的安全性,CRP可作为OSAHS患者炎症反应严重程度及疗效判断的参考指标。

Clinical significance of serum CRP detection before and after UPPP surgery for severe OSAHS patients

Objective To explore the changes and significance of serum C- reactive protein（ CRP） in severe obstructive sleep apnea hypopnea syndrom（ OSAHS） patients before and after the improved uvulopalatopharyngoplasty（ UPPP） treatment assisted by plasma. Methods Serum CRP level in 30 cases of severe OSAHS patients with an oropharyngeal level collapse before and after the preoperative continuous positive airway pressure（ CPAP）treatment and 1 week,3 months and 6 months after low- temperature plasma assisted by the improved UPPP was measured by immune turbidimetry. Meantime,serum CRP in 10 cases of healthy volunteers as the control group was measured. Results Serum CRP level in OSAHS patients was significantly higher than that in healthy volunteers（ P〈0. 01）. Serum CRP level 1 week after CPAP therapy was lower than that before CPAP treatment（ P〈0. 05）.Serum CRP levels 1 week,3 months and 6 months after UPPP were（ 7. 78 ± 0. 4） mg / L,（ 3. 12 ± 0. 28） mg / L and（ 3. 46 ± 0. 82） mg / L,respectively. AHI monitored by PSG 1 week,3 months and 6 months after UPPP were（ 24. 5 ±11. 2） /h,（ 4. 5 ± 3. 1） /h and（ 5. 2 ± 1. 6） /h with the lowest oxygen saturation（ Sa O2） of（ 80. 2 ± 4.8） %,（ 90. 3 ± 3. 1） % and（ 89. 6 ± 3. 2） %. Conclusion Preoperative CPAP therapy could decrease the serum CRP level and improve the security of UPPP operation and CRP could be used as a reference index for the severity of inflammatory response and the curative effect judgment in OSAHS patients.