阻塞性睡眠呼吸暂停综合征患者血清白细胞介素8和单核细胞趋化蛋白1水平的变化及意义

Changes and significances of serum interleukin-8 and monocyte chemoattractant protein-1 levels in patients with obstructive sleep apnea syndrome

目的 了解阻塞性睡眠呼吸暂停综合征 (OSAS)患者血清白细胞介素 8(IL 8)和单核细胞趋化蛋白 1(MCP 1)的变化及经鼻持续气道正压通气 (nCPAP)治疗对其影响。方法 采用酶联免疫吸附测定法检测 2 8例OSAS患者、2 0例健康对照者及 10例经nCPAP治疗后的中、重度OSAS患者血清IL 8和MCP 1水平。结果 OSAS患者血清IL 8和MCP 1水平分别为 (34.5 2± 10 .36 )ng/L、(99.71± 2 1.4 3)ng/L ,健康对照组分别为 (2 0 .6 9± 7.18)ng/L、(4 5 .93± 14 .0 9)ng/L ,两者比较差异有统计学意义 (均P <0 .0 1) ;OSAS患者血清IL 8水平与呼吸暂停低通气指数(AHI)、指端血氧饱和度 (SaO2 ) <90 %睡眠时间占总睡眠时间比例 (SIT90 )呈正相关 (r分别为 0 .6 5 4、0 .4 0 5 ,均P <0 .0 5 ) ,与最低血氧饱和度 (LSaO2 )、平均血氧饱和度 (MSaO2 )呈负相关 (r分别为 - 0 .5 0 4 ,- 0 .4 84 ,均P <0 .0 1) ;血清MCP 1水平与AHI、SIT90 呈正相关 (r分别为 0 .6 91,0 .5 32 ,均P <0 .0 1) ,与LSaO2 、MSaO2 呈负相关 (r分别为- 0 .6 19,- 0 .5 2 3,均P <0 .0 1) ;10例中、重度OSAS患者经nCPAP治疗半年后血清IL 8和MCP 1水平明显下降 ,与治疗前相比差异有统计学意义 (均P <0 .0 1)。

Objective To investigate the changes and significances of serum interleukin-8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) in patients with obstructive sleep apnea syndrome (OSAS) and effects of the cytokines by nasal continuous positive air pressure(nCPAP) treatment. Methods Twenty-eight OSAS patients, 20 healthy subjects were recruited as the control group, 10 patients with moderate and severe OSAS have been treated by nCPAP for over half a year. Serum IL-8 and MCP-1 levels were measured by enzyme-linked immunosorbent assay(ELISA). Results The serum IL-8 and MCP-1 levels were significantly higher in OSAS patients[( 34.52± 10.36) ng/L, ( 99.71± 21.43) ng/L, respectively] than those in the controls[( 20.69± 7.18) ng/L, ( 45.93± 14.09) ng/L, respectively] (P< 0.01); In OSAS patients, serum IL-8 levels were correlated positively with apnea hypopnea index(AHI) and percentage of time spent at SaO 2 below 90% during the total sleep period (SIT 90) (r= 0.654, 0.405, P< 0.01, P< 0.05) and were correlated negatively with lowest oxygen desaturation(LSaO 2) and mean oxygen desaturation(MSaO 2) (r= -0.504, -0.484, P< 0.01, P< 0.01), the levels of serum MCP-1 were correlated positively with AHI and SIT 90(r= 0.691, 0.532,P< 0.01, P< 0.01) and were correlated negatively with LSaO 2 and MSaO 2(r= -0.619, -0.523, P< 0.01, P< 0.01); After over half a year nCPAP treatment, obvious decrease in serum IL-8 and MCP-1 levels were observed in 10 moderate and severe OSAS patients compared with those of baseline in them(P< 0.01). Conclusion In OSAS patients,hypoxic caused by sleep apnea increases the serum IL-8 and MCP-1 levels which may be involved in the pathogenesis of OSAS-associated atherosclerosis; Treatment of OSAS using nCPAP is a potential approach to prevent the emergence of OSAHS-associated atherosclerosis via down-regulation of IL-8 and MCP-1 generation.