阻塞性睡眠呼吸暂停低通气综合征患者炎症因子水平变化

Study of inflammatory factors 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(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者血浆炎症因子水平以及手术治疗对炎症因子水平的影响。方法对60例经多导睡眠监测(polysomnography,PSG)确诊的重度OSAHS患者行悬雍垂腭咽成形术(uvulopalatopharyngoplasty,UPPP),另选择22例年龄、性别和体重指数(body mass index,BMI)等均相匹配的健康者作为对照。采用层析及放射免疫测定法,测定OSAHS患者术前以及术后6个月血清肿瘤坏死因子α(tumor necrosis factor-alpha,TNF-α)、白细胞介素6(interleukin-6,IL-6)和、白细胞介素8(interleukin-8,IL-8)水平。结果OSAHS组血清TNF-α、IL-6和IL-8水平显著高于对照组(P<0.01),60例OSAHS患者术后6个月TNF-α、IL-6和IL-8明显低于术前(P<0.01)。结论OSAHS患者血浆炎症因子失衡,其原因可能与夜间反复多次发作呼吸暂停及低氧血症有关,有效的手术治疗可使炎症因子趋于平衡。

OBJECTIVE To investigate the levels of tumor necrosis factor-alpha（TNF-α）, Lnterleukin- 6（IL-6）, and Interleukin-8（IL-8） in patients with obstructive sleep apnea-hypopnea syndrome（OSAHS ） before and after operation, and to evaluate the effect of surgical treatment on the levels of these inflammatory factors. METHODS Sixty severe OSAHS patients underwent uvulopalatopharyngoplasty were selected as OSAHS group and matched for age, sex, BMI to 22 health persons as control group. Serum levels of TNF-α, IL-6 and IL-8 were measured by chromatography and radioimmunoassay methods before and 6 months after operation. RESULTS The serum levels of TNF-α, IL-6 and IL-8 in OSAHS group were significantly higher than those in the control group （P〈0.01）, and the levels in OSAHS group 6 months after operation were significantly lower than those before operation （P〈0.01）. CONCLUSION Serum levels of inflammatory factors in OSAHS patients were out of balance. This might be related to the apnea and hypoxemia occurred repeatedly during nighttime. Effective operation could make the inflammatory factors trend to balance.