睡眠呼吸暂停综合征患者外周血白细胞介素-6和肿瘤坏死因子-α水平的变化

Role of interleukin-6 and tumor necrosis factor-α in obstructive sleep apnea syndrome

目的:探讨阻塞型睡眠呼吸暂停综合征(OSAS)患者外周血白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平的变化在发病机制中的作用。方法:①采用放射免疫法检测24例OSAS患者及20例正常人血浆IL-6、TNF-α水平,比较其组间差异,并分析OSAS患者血浆IL-6、TNF-α水平与睡眠呼吸紊乱指数(AHI)和最低血氧饱和度(SaO2)的相关性;②OSAS组患者进行持续气道正压通气(CPAP)治疗,3个月后复查上述各项指标,比较治疗前后血浆中IL-6、TNF-α水平的变化。结果:①OSAS组血浆IL-6和TNF-α水平较对照组升高〔(25.92±4.48)pg/ml vs(13.21±1.97)pg/ml,(11.27±2.60)pg/ml vs(5.83±0.99)pg/ml,P均<0.05〕。OSAS患者血浆IL-6和TNF-α水平与AHI呈正相关(r分别为0.456、0.464,P均<0.05),与其最低SaO2呈负相关(r分别为-0.495、-0.483,P均<0.05);②OSAS患者用CPAP治疗后,血浆IL-6、TNF-α水平较治疗前减低〔(25.92±4.48)pg/ml vs(15.37±1.78)pg/ml,(11.27±2.60)pg/ml vs(6.79±0.87)pg/ml,P均<0.05〕。结论:OSAS患者外周血IL-6、TNF-α水平升高与其低氧血症有关;CPAP可改善OSAS患者缺氧状态,降低外周血IL-6、TNF-α水平。

Objective： To explore the role of interleukin-6 and tumor necrosis factor-α level in the pathogenesis of obstructive sleep apnea syndrome. Methods ： The plasma IL- 6 and TNF - α level were detemained in 24 patients with obstructive sleep apnea syndrome and 20 healthy persons by radio-immunity assay and compared with resuits from patients treated with continuous positive airway pressure （CPAP） for three months. The correlation between IL-6 or TNF-α level, and apnea hypopnea index （AHI） or the minimum saturation of blood oxygen were analyzed. Results： The level of IL-6 and TNF-a were higher in OSAS patients than those in the controls [ （25.92 ± 4.48）pg/ml vs （13.21 ± 1.97）pg/ml, （5.83_± 0.99）pg/ml vs （11.20±3.01）pg/ml] （P 〈0.05）. The level of IL-6 or TNF-α were positively correlated with the AHI （ r = 0.456, r = 0. 464, P 〈 0.05 ） and negatively correlated with the minimum saturation of blood oxygen（ r = - 0.495, r = - 0.483, P 〈 0.05）. The level of IL-6 or TNF-α decreased from （15.37 ± 1.78） pg/ml to （6.79 ± 0.87）pg/ml after the treatment of CPAP. Conclusion： ①The level of IL-6 or TNF-α increases in OSAS patients; ②The increase of IL-6 or TNF-α is correlated with hypoxemia; ③Hypoxia and the level of IL-6 or TNF-α can be improved by CPAP in OSAS patients.