阻塞性睡眠呼吸暂停低通气综合征患者血清8-isoprostane、GSH-Px的研究

The Investigation of Serum 8-Isoprostane,GSH-Px in Patients with Obstructive Sleep Apnea/hypopnea Syndrome.

目的研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清8-异前列腺素(8-isoprostane)及谷胱甘肽过氧化物酶(GSH-Px)的表达,探讨OSAHS患者体内氧化应激的改变。方法研究纳入15例原发性鼾症及65例OSAHS患者。所有患者收集一般临床资料,采用多导睡眠仪整晚检测取得睡眠资料。用ELISA法检测血清8-isoprostane的表达,分光光度计法检测血清GSH-Px的表达。结果 (1)8-Isoprostane在原发性鼾症组、轻中度OSAHS组及重度OSAHS组中表达的量逐步增加;GSH-Px在此3组中表达的量逐渐减少。(2)8-Isoprostane与AHI、ODI、CT90%、平均SaO2、最低SaO2、ESS、BMI均存在相关性,相关系数r值从AHI至BMI逐渐减小。(3)GSH-Px与ODI、AHI、平均SaO2、CT90%、ESS、最低SaO2、BMI同样存在相关性,相关系数r值从ODI至BMI逐渐减小。结论 (1)OSAHS伴有氧化应激的增强。(2)与低氧严重程度相比,氧化应激与氧减次数的联系更密切。(3)CT90%是比最低SaO2更好的间接反映氧化应激程度的低氧严重度指标。

Objective To investigate the expression of Serum 8-isoprostane,glutathione peroxidase(GSH-Px) in patients with obstructive sleep apnea/hypopnea syndrome(OSAHS),and explore changes of oxidative stress in patients with OSAHS.Methods 15 patients with simple snoring and 65 patients with OSAHS were internalized in the study.After being collected common clinical data,all patients underwent a single-night polysomnogram to get polysomnogram variables.Serum 8-isoprostane was measured by enzyme-linked immunosorbent assay(ELISA),and serum glutathione peroxidase(GSH-Px) was measured by spectrophotometer.Result 1.The levels of 8-isoprostane increase gradually with the increase of apnea hypopnea index(AHI),while the levels of GSH-Px decrease gradually with the increase of AHI.2.8-Isoprostane correlates with AHI,oxygen desaturation index(ODI),cumulative percentage of sleep time with SaO2 below 90%(CT90%),average SaO2,minimum SaO2,Epworth sleepiness scale(ESS),body mass index(BMI) respectively,meanwhile,correlation coefficient(r) decreased gradually from AHI to BMI.3.GSH-Px also correlates with ODI,AHI,average SaO2,CT90%,ESS,minimum SaO2,BMI respectively,and r decreased gradually from ODI to BMI.Conclusion 1.The severity of OSAHS is independently associated with oxidative stress.2.Oxidative stress correlates with frequency of desaturation more strongly than with severity of desaturation.3.CT90%is an indirect indicatrix of oxidative stress better than minimum SaO2.