粘附分子在阻塞性睡眠呼吸暂停低通气综合征以及冠心病中的作用

The Role of Adhesion Molecules in the Pathogenic Mechanisms of Coronary Heart Disease and Obstructive Sleep Apnea-hypopnea Syndrome

目的:探讨细胞粘附分子在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)及冠心病(CHD)发病中的作用。方法:应用酶联免疫吸附测定(ELISA)方法检测30例OSAHS患者,30例CHD患者,30例OSAHS合并CHD患者及30例健康对照者血清可溶性细胞间粘附分子(ICAM-1)、血管细胞粘附分子1(VCAM-1)和E-选择素的含量。结果:OSAHS组、CHD组、OSAHS合并CHD组患者血清ICAM-1[分别为(245.22±71.19)ng.ml-1、(238.02±55.34)ng.ml-1(、223.10±41.61)ng.ml-1]、VCAM-1[分别为((24.01±4.79)ng.ml-1、(30.35±12.68)ng.ml-1、(26.86±10.11)ng.ml-1)、E-选择素[分别为(86.58±48.02)ng.ml-1、(56.40±20.12)ng.ml-1、(54.91±31.56)ng.ml-1]含量均明显高于健康对照组[分别为(176.17±25.48)ng.ml-1、(17.14±4.93)ng.ml-1、(31.44±11.34)ng.ml-1],差异有显著性(P<0.01);而OSAHS组患者E-选择素明显高于CHD组及OSAHS合并CHD组,差异有显著性(分别为P<0.05,P<0.01);而CHD组患者VCAM-1含量明显高于OSAHS组,差异有显著性(P<0.05);ICAM-1、E-选择素水平与睡眠呼吸暂停低通气指数(AHI)呈明显正相关(P<0.01);ICAM-1水平与最低血氧饱和度(SaO2min)呈明显负相关(P<0.01)。结论:血清粘附分子ICAM-1、VCAM-1、E-选择素作为重要的促炎症介质在OSAHS、CHD及OSAHS合并CHD患者中表达增加,粘附分子水平升高是OSAHS合并CHD患者的冠心病进展的重要危险因素之一。

Objective： To explore the role of adhesion molecules in the pathogenesis of coronary heart disease and obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods： The levels of serum soluble intercellular adhesion molecule-1 （ICAM-1）, vascular cell adhesion molecule-1 （VCAM- 1） and E-selectin in 30 OSAHS patients, 30 CHD patients, 30 OSAHS patients accompanied by CHD, 30 healthy controls were measured by enzyme-linked immunosorbent assay （ELISA） method. Results： The levels of serum soluble ICAM-1 [（245.22±71.19）ng · ml^-1 , （238.02±55.34） ng · ml^-1 , （223. 10±41. 61） ng · ml^-1 , respectively], VCAM-1 [（24.01±4.79） ng · ml^-1 , （30.35±12.68） ng · ml^-1 , （26.86±10.11） ng · ml^-1 , respectively] and E-selectin [（86.58± 48.02） ng · ml^-1 , （56.40±20.12） ng · ml^-1 , （54.91±31.56） ng · ml^-1 , respectively] were significantly higher in OSAHS, CHD and OSAHS accompanied by CHD than those in the healthy controls [（176.17±25.48）ng · ml^-1, （17. 14±4. 93） ng · ml^-1, （31.44±11.34） ng · m1^-1, P 〈0.01, respectively]. The levels of serum E-selectin were significantly higher in OSHAS than those in CHD and OSAHS accompanied by CHD （P〈0.05, P〈0.01）. The levels of serum VCAM-1 were significantly higher in CHD than those in OSAHS （P〈0.05）. There were conditon higher in CHD than those in OSAHS （P〈0.05）. The concentration of both ICAM-1 and E-selectin was a significantly positive correlation to the apnea hyponea index （AHI） in the 30 OSAHS patients （P〈0.01）. There was a significantly negative correlation between the concentration of ICAM-1 and the lowest oxygen desaturation in the 30 OSAHS patients （P〈0. 01）. Conclusion. The high level of serum of ICAM-1, VCAM-1 and E-selectin is an important risk factor for the development of CHD in OSAHS patients.