阻塞性睡眠呼吸暂停低通气综合征患者血清白三烯B4水平的研究

目的 研究不同程度OSAHS患者血清白三烯B4 (leukotriene B4,LTB4)的水平,探讨OSAHS患者发生心血管疾病的可能机制.方法 经多导睡眠图(polysomnography,PSG)监测确诊为OSAHS患者48例,根据呼吸暂停低通气指数(apnea-hypopnea index,AHI)分为轻、中、重3组,行PSG筛查除外OSAHS者12例,作为正常对照组,各组均于PSG监测后采空腹静脉血,应用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)检测血清LTB4水平.结果 ①与对照组比较,中、重度OSAHS组血清LTB4水平升高,差异有统计学意义(P值均＜0.05);轻度OSAHS组与对照组比较差异无统计学意义(P＞0.05).②OSAHS患者血清LTB4水平与AHI、氧减指数(oxygen desaturation index,ODI)、血氧饱和度小于0.9时间占睡眠时间百分比(percentage of time spend when oxygensaturation lower than 0.9,SLT90％)、最长呼吸暂停时间(longest apnea time,LAT)呈显著正相关(r值分别0.582、0.516、0.577、0.577,P值均＜0.01),与夜间最低血氧饱和度(minimal satuation of blood oxygen,SaO2 min)呈显著负相关(r=-0.620,P＜0.01).③多元逐步回归结果显示,SaO2 min是影响OSAHS患者血清LTB4水平的独立危险因素(R2 =0.385,P＜0.01).结论 OSHAS患者血清LTB4水平明显升高,缺氧严重程度与OSHAS患者血清LTB4水平密切相关.

Study of leukotriene B4 in patients with obstructive sleep apnea-hypopnea syndrome

Objective To investigate the level of serum leukotriene B4 (LTB4) in patients with different severity in obstructive sleep apnea-hypopnea syndrome (OSAHS),and to explore the probable mechanisms of cardiovascular diseases in patients with OSAHS.Methods Forty-eight subjects,who were diagnosed as OSAHS by PSG,were studied.Those patients were divided into three groups (mild,moderate,severe) according to AHI.Another 12 healthy individuals were as a control group.The fasting venous bloods were obtained after PSG for all subjects.The concentrations of serum LTB4 were measured by ELISA.Results ①The level of serum LTB4 in moderate and severe OSAHS group was higher than that in control group (all P ＜0.05).There was no significant difference between mild OSAHS group and control group (P ＞ 0.05).②The level of serum LTB4 was positively correlated with AHI,ODI,SLT90％ and LAT (r =0.582,0.516,0.577 and 0.577 respectively,all P ＜0.01),and was negatively correlated with SaO2 min (r =-0.620,P ＜0.01).③Multiple regression analysis showed that the level of SaO2 min was the independent risk factor to influence the level of serum LTB4 in patients with OSAHS (R2 =0.385,P ＜0.01).Conclusions The level of serum LTB4 was significantly increased.It suggested that the level of serum LTB4 was closely related with severity of hypoxia in patients with OSAHS.