基质金属蛋白酶-9与游离脂肪酸在重度OSAHS患者血清中的表达及研究

Research on the serum levels of matrix metalloproteinase-9 and free fatty acids in OSAHS cases

目的:探讨基质金属蛋白酶-9(MMP-9)、游离脂肪酸(FFA)在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清中的表达和相互关系,以及MMP-9、FFA、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)与AHI、LSaO2的相关性。方法:选取50例经我科睡眠呼吸监测诊断为重度OSAHS且拥有完整临床资料的患者。选取50例经嗜睡量表评分并排除OSAHS的体检者作为对照组。两组间BMI和年龄比较差异均无统计学意义(均P>0.05)。所有对象都在睡眠监测状态中,每位患者晨起后空腹抽取静脉血3ml,各3份,其中2份分别做TG、TC、HDL-C、LDL-C检查和采用比色法测定FFA,另1份放入-75℃冰箱冻存,用酶联免疫分析技术测定血清MMP-9。运用SPSS 13.0统计软件对所有相关数据进行处理分析。结果:①重度OSAHS患者血清MMP-9、FFA浓度与对照组相比均显著增高(均P<0.01)。重度OS-AHS患者TG、TC、HDL-C、LDL-C浓度与对照组相比增高(P<0.05)。②重度OSAHS患者血清FFA浓度与TG、BMI、AHI之间呈正相关,与LSaO2呈负相关。重度OSAHS患者血清MMP-9浓度与FFA、AHI之间呈正相关,与LSaO2呈负相关。③重度OSAHS患者血清FFA浓度与MMP-9浓度呈直线相关,二者之间呈正相关。结论:OSAHS患者较无OSAHS人群的内分泌紊乱和心血管的危险性增加。OSAHS患者血清MMP-9和FFA的表达同时增高提示OSAHS患者的危险性较单一表达异常更高。

Objective：To study the expression of matrix metalloproteinase-9（MMP-9） and free fatty acids（FFA） in obstructive sleep apnea-hypopnea syndrome（OSAHS） patients.And the relativity among the serum level of MMP-9,FFA,four factors of blood lipids,hypopnea index（AHI）,minimum oxygen saturation,body mass index（BMI） in OSAHS patients.Method：Fifty cases diagnosed of OSAHS,with integral clinical data in our department,were enrolled in the research.Fifty cases were selected as control group by the sleepiness scale score and the exclusion of the physical examination OSAHS.There was no significant difference（P0.05） of the body mass index（BMI） and age in the two groups.Two fasting venous blood samples of 3 ml were taken from every object in the morning wake from sleep monitoring and kept at room temperature for 30 min.The samples were sent to the laboratory to test the four factors of blood lipid and the FFA by colorimetric determination.Another fasting venous blood samples of 3ml was preserved in refrigerator at-75℃,used for serum MMP-9 test with Enzyme-linked immunoadsordent assay（ELISA）.SPSS 13.0 statistical software was used for all relevant data processing and analysis.Result：Serum levels of MMP-9 and FFA in severe OSAHS cases were significantly higher than those in control group（P0.01）.Serum four factors of blood lipids level of severe OSAHS was a little higher（P0.05） than those in control group.There were a close relationship among serum FFA and TG,LSaO2,BMI and AHI in severe OSAHS patients.Serum FFA level was positively related with TG,BMI and AHI and negatively related with LSaO2.There were also a close relationship among serum MMP-9 and FFA,LSaO2 and AHI.The serum MMP-9 was positively related with FFA and AHI and negatively related with LSaO2.There was a positive linear correlation between serum FFA concentration and MMP-9 concentration in severe OSAHS cases.Conclusion：The higher risk of endocrinopathy and cardiovascular diseases were happened in OSAHS patients.The higher expression of both MMP-9 and FFA in OSAHS cases suggested a higher risk than that of the single high expression of them.