睡眠呼吸暂停综合征病人IL-6、CRP、IMT的研究

RESEARCH ON IL-6,CRP AND IMT IN PATIENTS WITH SLEEP APNEA SYNDROME

目的:通过测定睡眠呼吸暂停综合征(SAS)病人血浆炎症细胞因子:白介素-6(IL-6),C反应蛋白(CRP)的水平及测量颈动脉内膜中膜厚度(IMT),并研究三者与睡眠呼吸暂停/通气不足指数(AHI)、最低血氧饱和度之间的关系,探讨SAS导致或加重动脉粥样硬化的机制。方法:SAS组30例,正常对照组30例,两组均行多导睡眠仪监测,次日晨分别测定血浆IL-6、CRP的水平及血糖、血脂、血压的值,并用彩超测量各组IMT的值。结果:SAS组与对照组比较,血浆IL-6水平显著增高(1.34±0.21 pg/mL比0.53±0.24 pg/mL,P<0.01),血浆CRP水平显著增高(5.16±1.16 mg/L比1.65±0.75 mg/L,P<0.01)。IMT显著增大(1.43±0.25 mm比0.77±0.13mm,P<0.01)。IL-6与AHI呈正相关(r=0.766,P<0.01),而与LSaO2呈负相关(r=-0.47,P<0.01)。CRP与LSaO2呈负相关(r=-0.83,P<0.01),而与AHI呈正相关(r=0.872,P<0.01)。IMT与LSaO2呈负相关(r=-0.663,P<0.01),而与AHI呈正相关(r=0.796,P<0.01)。结论:SAS可能导致或加重动脉粥样硬化的发生和发展。

Objective：To determine the serum levels of C -reactive protein （CRP）, interleukin - 6 （IL- 6）and intima -media thickness （IMT） of carotid arterial wall in sleep apnea syndrome （SAS） patients and the control group. To investigate the relationship between CRP, IL - 6, IMT and apnea or hypopventilation index （ AHI）, lowest SaO2. To investigate the mechanism of SAS induced or aggravated atherosclerosis. Methods ：30 SAS patients and another 30 healthy subjects were recruited. The two groups were monitored by polysomnography. The serum levels of CRP, IL -6, blood sugar, blood lipids,blood pressure were examined in the next day. IMT was measured by means of color - Doppler ultrasonic examination. Results： Comparing with control group, the levels of IL - 6 （ 1.34 ± 0. 21 pg/mL VS 0. 53 ±0. 24 pg/mL, P 〈 0. 01 ） and the levels of CRP （5. 16 ± 1. 16 mg/L VS 1.65±0. 75 mg/ L, P 〈 0. 01 ） were significantly elevated in patients with SAS. There were significant difference between SAS group （ 1.43 ±0. 25 mm） and control group （0. 77 ±0. 13mm） in IMT （P 〈 0. 01 ） . IL -6 was positively correlated with AHI （ r = 0. 766, P 〈 0. 01 ） and negatively correlated with lowest SaO2 （ r = - 0. 47, P 〈 0. 01 ）. CRP was negatively correlated with LSaO2 （ r = - 0. 83, P 〈 0.01 ） and positively correlated with AHI （ r = 0. 872, P 〈 0. 01 ）. IMT was negatively correlated with lowest SaO2（r = -0. 663, P 〈 0. 01 ） and positively correlated with AHI （r =0. 796, P 〈 0. 01 ）. Conclusion：The levels of IL -6 and CRP were elevated and IMT was increased in patients with SAS. Therefore, SAS is probably implicated in initiation and progression of atherosclerosis.