阻塞性睡眠呼吸暂停/低通气综合征患者血清瘦素水平监测及相关性分析

Change of Serum Leptin Levels in Patients with Obstructive Sleep Apnea/Hypopnea Syndrome

目的 探讨阻塞性睡眠呼吸暂停 /低通气综合征 (OSAHS)患者血清瘦素水平的变化及其临床意义。 方法 35例OSAHS患者和 30例健康人 (对照组 ) ,用多导睡眠呼吸监测仪进行夜间 7h睡眠监测 ,睡前及清晨测量血压 ,抽取静脉血放射免疫法测定血清瘦素水平。 结果 (1)OSAHS组空腹血清瘦素水平显著高于对照组[(6 2 4± 1 5 1)ng/mL ,(4 4 1± 1 72 )ng/mL ,P <0 0 1]。平衡体质量指数 (BMI)后 ,差别仍有显著意义 [(6 0 3±1 6 2 )ng/mL ,(4 6 5± 1 34)ng/mL ,P <0 0 5 ]。 (2 )OSAHS组清晨舒张压显著高于睡前 [(89± 12 )mmHg ,(74±14 )mmHg ,P <0 0 1]。 (3)相关分析 ,血清瘦水平与睡眠呼吸暂停 /低通气指数 (AHI) (r =0 4 16 ,P <0 0 1)、体质量指数 (BMI) (r=0 2 93,P <0 0 5 )、SpO2 <90 %的时间 (r =0 385 ,P <0 0 1)呈正相关。对瘦素水平与其相关变量进行多因素逐步回归分析 ,入选变量依次为BMI、AHI、SpO2 <90 %的时间和DBP。 结论 OSAHS患者血清瘦素水平升高 ,且独立于肥胖因素 ,OSAHS本身是引起瘦素水平升高的原因。

Objective To explore the changes of serum leptin level in patients with obstructive sleep apnea/hypopnea syndrome. Methods Polysomnography was performed 7 hours at night in 35 patients with OSAHS and 30 healthy controls. Blood pressure was measured and peripheral venous blood sample were obtained before and after sleep. Serum leptin level was measured by radioimmunoassay. Results (1)serum leptin levels were significantly higher in OSAHS[OSAHS=(6.24±1.51)ng/mL; control objects=(4.41±1.72)ng/mL, P<0.01]. (2)Multivariate analysis showed leptin was positively related to BMI(r=0.293, P=0.021), apnea/hypopnea index(AHI, r=0.416, P=0.001), and oxygen desaturation time(r=0.385, P=0.003). Conclusion serum leptin levels in OSAHS were higher than in controls. Besides obesity, OSAHS may be another factor of higher leptin.