血浆硫氧还蛋白水平对阻塞性睡眠呼吸暂停低通气综合征的预测价值

The predictive value of plasma thioredoxin level for obstructive sleep apnea-hypopnea syndrome

目的:探讨血浆硫氧还蛋白(thioredoxin,TRX)水平在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)诊断中的价值。方法:经多导睡眠图(PSG)检查确诊OSAHS患者54例,分为轻、中、重3组(各为14、11及29例),另设对照组9例;ELISA法测定血浆TRX水平,比较血浆TRX水平在各组间差异及与睡眠呼吸事件相关指标的相关性,并对TRX水平诊断OSAHS的价值进行灵敏度、特异度评价。结果:血浆TRX水平随OSAHS严重程度呈逐渐升高趋势。对照组测得值为(8.62±2.14)ng/mL,轻、中、重度组分别为(13.33±5.60)ng/mL、(14.71±5.53)ng/mL和(16.10±7.34)ng/mL(F=3.465,P=0.022)。以TRX≥9.39ng/mL为临界值,预测OSAHS的灵敏度为90.7%、特异度为77.8%、准确率为88.7%;以TRX≥11.79ng/mL为临界值,鉴别轻度与中重度OSAHS时的灵敏度为75.0%、特异度为65.2%、准确率73.1%。结论:血浆TRX水平测定对OSAHS诊断及其严重程度评估具有一定预测价值。

Objective To study the value of plasma thioredoxin （TRX） for the diagnosis of obstructive sleep apneahypopnea syndrome （OSAHS）. Methods OSAHS patients diagnosed by polysomnography （PSG） were divided into three groups, mild, moderate and severe groups （14,11 and 29 cases, respectively ）; 9 normal cases were served as control. ELISA was used to detect plasma TRX. Plasma TRX levels among different groups and the relationship between TRX and sleep index were analyzed. The diagnosis value of TRX for OSAHS was evaluated by sensitivity, specificity, and accuracy. Results TRX level increased with the increase in severity of OSAHS. Levels of TRX in controls, mild, moderate and severe OSAHS groups were （8.62 ±2.14） ng/mL, （13.33 ±5.60）ng/mL, （14.71 ±5.53）ng/mL and （16.10 ±7.34）ng/mL, respectively （F=3.465, P=0.022）. When TRX 9.39 ng/mL was taken as the cutoff value, the predictive value for the diagnosis of OSAHS was with sensitivity 90.7%, specificity 77.8%, and accuracy 88.7%. And when 11.79 ng/mL was taken as the cutoff value, the predictive value for discriminating mild from moderate/severe OSAHS was with sensitivity 75.0%, specificity 65.2% and accuracy 73.1%. Conclusions Plasma TRX level has a predictive value for the diagnosis and estimation of severity of OSAHS.