nCPAP短期治疗对阻塞型睡眠呼吸暂停低通气综合征患者血清CRP和ICAM-1的影响

Effects of nasal continuous positive airway pressure short-term treatment on C-reactive protein and intercellular adhesion molecule-1 in patients with obstructive sleep apnea-hypopnea syndrome

目的:观察经鼻持续气道正压通气(nCPAP)短期治疗对阻塞型睡眠呼吸暂停低通气综合征(OS-AHS)患者血清C-反应蛋白(CRP)和细胞间黏附分子-1(ICAM-1)的影响。方法:选择20例中、重度OSAHS患者(AH I≥15)和15例对照者(AH I<15)进行血清CRP和ICAM-1水平的检测;对20例中、重度OSAHS患者进行4 dnCPAP短期治疗并检测治疗后血清CRP和ICAM-1水平。比较中、重度患者血清CRP和ICAM-1水平与对照者有无差别以及nCPAP短期治疗对OSAHS患者血清CRP和ICAM-1水平有无影响。结果:患者血清CRP水平与AH I呈正相关(r=0.615,P<0.001),与夜间平均SaO2呈负相关(r=-0.682,P<0.001),与夜间最低SaO2亦呈负相关(r=-0.61,P<0.001);血清ICAM-1水平与AH I呈正相关(r=0.751,P<0.001),与夜间平均血SaO2呈负相关(r=-0.68,P<0.001),与夜间最低SaO2亦呈负相关(r=-0.656,P<0.001);血清CRP水平与ICAM-1水平呈正相关(r=0.437,P=0.009)。中、重度OSAHS患者血清CRP,ICAM-1水平较对照者增高(P<0.01)。中、重度OS-AHS患者治疗后血清CRP,ICAM-1水平降低(P<0.01)。结论:OSAHS存在炎症反应,nCPAP短期治疗能减轻OSAHS患者机体的炎症反应。

Objective To investgate the effects of nasal continuous positive airway pressure （ nCPAP） short-term treatment on the serum level of C-reactive protein （CRP） and intercellular adhesion molecule-1 in obstructive sleep apnea-hypopnea syndrome （OSAHS） patients. Methods Twenty patients with OSAHS （ AHI ≥15 ） and 15 controls （ AHI 〈 15 ） were recruited. After polysomnography （PSG） , the venous blood was collected from all subjects to investigate CRP and ICAM-1. The effects of short-term treatment （4 d） of nCPAP on the serum levels of CRP and ICAM-1 were studied in patients with moderate and severe OSAHS. Results Before the treatment, there was a significant positive correlation between CRP and AHI in all subjects （r=0. 615, P〈0. 001 ）, a significant negative correlation between CRP and the mean nocturnal oxygen saturation （ r=- 0.682, P 〈0. 001 ） , and a significant negative correlation between CRP and the lowest nocturnal SaO2 （r=-0. 61, P 〈 0. 001 ）. There was a significant positive correlation between ICAM-1 and AHI in all subjects （r=0. 751, P 〈0. 001 ）, a significant negative correlation between ICAM-1 and the mean nocturnal oxygen saturation （ r=-0. 68,P〈0. 001 ）, and a significant negative correlation between ICAM-1 and the lowest nocturnal oxygen saturation （r=-0. 656, P 〈0. 001 ）. There was a significant positive correlation between CRP and ICAM-1 （r=0. 437, P=0. 009）. The levels of CRP and ICAM-1 were significantly higher in patients with moderate and severe OSAHS than in the controls （P 〈0.01 ）. nCPAP decreased the levels of CRP and ICAM-1 in patients with moderate and severe OSAHS （P〈0.01 ）. Conclusion Inflammatory reaction exists in OSAHS and can be palliated after nCPAP shorterm treatment.