睡眠呼吸暂停综合征患者sICAM-1水平测定及临床探讨

The determination of soluble intercellular adhesion molecule 1 (sICAM-1) and its clinical significance among patients with sleep apnea syndrome

目的探讨睡眠呼吸暂停综合征(SAS)患者可溶性细胞间黏附分子-1(sICAM-1)水平及其临床意义。方法选取SAS患者35例及20例年龄相匹配的健康对照者,采用ELISA法检测SAS患者入睡前、睡醒后血清sICAM-1水平,并与正常对照组比较。结果SAS患者入睡前及睡醒后sICAM-1水平均较正常对照组高(睡醒后:282.1±43.0 vs 206.7±6.5 ng/m l;入睡前:280.7±44.8 vs 206.1±6.3 ng/m l,P<0.01)。中重度SAS患者sICAM-1水平较轻度SAS患者升高(睡醒后:315.6±23.7 vs 248.6±29.1 ng/m l;入睡前:317.0±22.0 vs 244.4±28.8 ng/m l,P<0.01),夜间平均血氧饱和度(SaO2)<90%患者组sICAM-1水平高于平均SaO2≥90%患者组(睡醒后:315.6±23.7 vs 248.6±29.1 ng/m l;入睡前:320.7±15.0 vs 240.8±21.4 ng/m l,P<0.01)。结论监测sICAM-1不仅可以从分子水平了解SAS的发病机制,还可为临床开展抗黏附分子治疗提供理论基础;同时可作为评价SAS严重程度和治疗效果的简便、可靠的指标。

Objective To explore the level of soluble intercellular adhesion molecule 1 （sICAM-I） and its clinical significance among patients with sleep apnea syndrome （SAS）. Methods The concentration of sICAM-1 was measured in the serum by ELISA method before and after sleeping in 35 patients with SAS and 20 age-matched healthy controls. Results The sICAM-1 levels increased in the SAS patients before and after sleeping compared with that in normal controls （ after sleeping ： 282.1 ± 43.0 vs 206.7 ± 6.5 ng/ml ; before sleeping ： 280.7 ± 44.8 vs 206.1 ± 6.3 ng/ml,P 〈：0. 01 ）. The sICAM-1 levels of the moderate and severe SAS patients were significantly higher than those of the mild （ after sleeping： 315.6 ± 23.7 vs 248.6 ± 29.1 ng/ml ; before sleeping： 317.0± 22.0 vs 244.4 ± 28.8 ng/ml ,P 〈： 0. 01）. The sICAM-I levels of the SAS patients whose mean blood oxygen saturation （SaO2 ） 〈 90% were higher than those of the patients whose mean SaO2≥90% （ after sleeping：320.4 ± 16.2 vs 243.7 ± 18.9 ng/ml; before sleeping： 320.7 ± 15.0 vs 240.8 ±21.4 ng/ml,P 〈： 0. 01 ）. Conclusions Determination of sICAM-1 could not only understand pathogenesis of SAS from molecule level, but also provide the theoretical foundation for anti-adhesion molecules treatment clinically; at the same time which could serve as a simple and convenient,reliable method of appraising SAS severity and curative effect.