阻塞性睡眠呼吸暂停低通气综合征呼出气冷凝液8-异前列烷的昼夜变化及其意义

Change and significance of 8-isoprostane in exhaled breath condensate in 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）患者呼出气冷凝液（exhaled breath condensate，EBC）8-异前列烷（8-isoprostane，8-isoPG）的昼夜变化及其意义。方法采用德国JAEGER公司的呼出气收集器，收集40例OSAHS患者和30名正常对照者睡眠监测前后的EBC，同时采集睡眠监测后的血清，采用酶联免疫技术测定EBC及血清中8-isoPG的含量，并与睡眠监测指标进行相关性分析。结果0SAHS组EBC中8-isoPG睡眠监测前为（13．08±1.42）ng／L、睡眠监测后为（14．93±1.39）ng／L（P〈0．01）。正常对照组EBC中8-isoPG睡眠监测前为（11．06±0．72）ng／L、睡眠监测后为（10．97±0．70）ng／L（P〉0．05）。OSAHS组睡眠监测后EBC及血清中8-isoPG比正常对照组升高，P〈0．01。OSAHS患者睡眠监测后EBC8-isoPG与血清8-isoPG呈正相关（r=0．685，P〈0．01），与AHI呈正相关（r=0．650，P〈0．05），与睡眠中最低血氧饱和度、基础血氧饱和度和平均血氧饱和度呈负相关（r=-0．406，-0．439，-0．454，P值均〈0．05）。结论0SAHS患者存在夜间氧化应激反应增强．OSAHS患者早晨EBC中8-isoPG可以作为评价患者氧化应激状态和估计病情严重程度的较好指标。

Objective To study the changes of 8-isoprostane（8-isoPG） in exhaled breath condensate （EBC） in patients of obstructive sleep apnea-hypopnea syndrome （OSAHS） and discuss their clinic significance. Methods Forty OSAHS patients and 30 normal controls were included in the study. EBC before and after polysomnography（PSG） were collected by Ecosreen made in JAEGER Company in German. Serum after PSG was collected as well. EBC and serum 8 isoPG were measured by enzyme-linked immunosorbent assay. Results The concentration of 8-isoPG in EBC was （13.08±1.42） ng/L before PSG, （14.93 ±1.39 ） ng/L after PSG in 40 OSAHS patients（ P〈0.01） ,and （11.06±0.72） ng/L before PSG,（10. 97±0.7） ng/L after PSG in 30 normal controls （P 〉 0.05）. The concentration of 8-isoPG in EBC after PSG was significantly higher than that in normal controls （ P G0.01）. The serum level of 8-isoPG was significantly higher in 40 OSAHS patients than that in 30 normal controls,（36.59±14.89） ng/L vs （19.91±7.76） ng/L （ P 〈0.01）. The concentration of 8-isoPG in EBC of OSAHS patients after PSG was correlated positively with serum 8 isoPG level （ r =0. 685, P〈0.01）. The concentration of 8 isoPG in EBC of OSAHS patients after PSG was correlated positively with AHI （ r =0. 650, P〈0.01） and negatively with LSpO2 ,FSpO2 , MSpO2 （ r =-0. 406,-0. 439,-0. 454,all P 〈0.05）. Conclusions These findings suggest that oxidative stress is characteristic in OSAHS patients. The level of 8 isoPG in EBC depends on the severity of the OSAHS and may prove to be useful in monitoring of airway oxidative stress of OSAHS.