阻塞性睡眠呼吸暂停综合征患者外周血ghrelin PTX3 TNF-α IL-6水平与心肌损伤的关系分析

doi:10.3969/j.issn.1006-6233.2021.06.013

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摘要 目的: 研究阻塞性睡眠呼吸暂停综合征(OSAHS)患者外周血ghrelin、PTX3、TNF-α,IL-6水平与心肌损伤的关系。方法: 选取2018年6月至2020年6月于我院接受诊治的OSAHS患者88例,根据多导睡眠仪检测的呼吸暂停指数分为轻度组(5<AHI≤15)33例,中度组(15<AHI≤30)31例,重度组(AHI>30)24例,另选取同期健康体检者30(AHI≤5)例作为健康组进行对照。检测各组受试者外周血ghrelin、PTX3、TNF-α、IL-6水平与心肌损伤标志物NT-proBNP、HFABP、cTnI水平并进行比较,采用Pearson检验分析患者以上指标的相关性。结果: OSAHS患者各组较健康组ghrelin、PTX3、TNF-α、IL-6水平显著升高,且ghrelin、PTX3、TNF-α、IL-6水平随轻度组、中度组、重度组顺序依次升高(P均<0.001)。OSAHS患者各组较健康组NT-proBNP、HFABP、cTnI水平显著升高,且NT-proBNP、HFABP、cTnI水平随轻度组、中度组、重度组顺序依次升高(P均<0.001)。OSAHS患者ghrelin水平与NT-proBNP、HFABP、cTnI水平均呈负相关(r=-0.384,r=-0.653,r=-0.498;P<0.001);OSAHS患者PTX3水平与NT-proBNP、HFABP、cTnI水平均呈正相关(r=0.892,r=0.740,r=0.823;P<0.001);OSAHS患者TNF-α水平与NT-proBNP、HFABP、cTnI水平均呈正相关(r=0.680,r=0.657,r=0.760;P<0.001)OSAHS患者IL-6水平与NT-proBNP、HFABP、cTnI水平均呈正相关(r=0.674,r=0.666,r=0.778;P<0.001)。结论: ghrelin、PTX3、TNF-α、IL-6水平与心肌损伤存在重要关联,可能是因呼吸不通畅和间歇性缺氧引起的炎性反应进而对心血管造成损伤,因此在对OSAHS的治疗过程中要注意监测其炎性因子水平。

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关键词 ：阻塞性睡眠呼吸暂停综合征, 心肌损伤, TNF-α, IL-6

Abstract：Objective: To study the correlation between peripheral blood ghrelin, PTX3, TNF-α, IL-6 levels and myocardial injury in patients with obstructive sleep apnea syndrome. Methods: A prospective selection of 88 patients with OSAHS who were diagnosed and treated in our hospital from June 2018 to June 2020 were divided into mild group (5<AHI≤15) with 33 cases according to the apnea index detected by polysomnography. There were 31 cases in the moderate group (15<AHI≤30), 24 cases in the severe group (AHI>30), and 30 healthy persons (AHI≤5) in the same period in the healthy group for control. Peripheral blood ghrelin, PTX3, TNF-α, IL-6 levels and myocardial injury markers NT-proBNP, HFABP, cTnI levels were detected and compared in each group. Pearson test was used to analyze the correlation of the above indicators. Results: The levels of ghrelin, PTX3, TNF-α, and IL-6 in each group of OSAHS patients were significantly higher than those in the healthy group, and the levels of ghrelin, PTX3, TNF-α, and IL-6 followed the order of mild, moderate, and severe increasingly (P<0.001). The levels of NT-proBNP, HFABP, and cTnI in each group of OSAHS patients were significantly higher than those in the healthy group, and the levels of NT-proBNP, HFABP, and cTnI increased in the order of the mild group, moderate group, and severe group (P<0.001). OSAHS patients' ghrelin level was negatively correlated with NT-proBNP, HFABP, cTnI levels (r=-0.384, r=-0.653, r=-0.498; P<0.001); OSAHS patients' PTX3 level was correlated with NT-proBNP, HFABP, cTnI. The level was positively correlated (r=0.892, r=0.740, r=0.823; P<0.001); the level of TNF-α in OSAHS patients was positively correlated with the levels of NT-proBNP, HFABP, and cTnI (r=0.680, r=0.657, r =0.760; P<0.001) IL-6 levels in OSAHS patients were positively correlated with NT-proBNP, HFABP, and cTnI levels (r=0.674, r=0.666, r=0.778; P<0.001). Conclusion: The levels of ghrelin, PTX3, TNF-α, and IL-6 are importantly related to myocardial damage, which may be caused by the inflammatory reaction caused by impaired breathing and intermittent hypoxia, which may damage the cardiovascular system. Therefore, attention should be paid in the treatment of OSAHS to monitoring the level of inflammatory factors.

Key words： OSAHS Myocardial injury TNF-α IL-6

基金资助:四川省卫生和计划生育科研课题项目,(编号:17PJ046)

引用本文:

杨燕琼, 罗美, 雷清, 陈涛, 余晓丹. 阻塞性睡眠呼吸暂停综合征患者外周血ghrelin PTX3 TNF-α IL-6水平与心肌损伤的关系分析[J]. 河北医学, 2021, 27(6): 939-942.
YANG Yanqiong, LUO Mei, LEI Qing, et al. An Analysis of the Correlation Between the Levels of Peripheral Blood Ghrelin PTX3 TNF-α IL-6 and Myocardial Injury in Patients with Obstructive Sleep Apnea Syndrome. HeBei Med, 2021, 27(6): 939-942.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2021.06.013 或 http://www.hbyxzzs.cn/CN/Y2021/V27/I6/939

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