ACI合并OSAHS患者血清TNF-α、hs-CRP水平变化

Changes of Serum TNF-α and hs-CRP Levels in ACI Associated OSAHS Patients

目的:探讨急性脑梗死(acute cerebral infarction,ACI)合并阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者血清肿瘤坏死因子(tumor necrosis factor alpha,TNF-α)和超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)水平变化及临床意义。方法:分别采用双抗体夹心ELISA和乳胶增强免疫比浊法测定32例健康体检者、36例ACI、28例OSAHS以及30例ACI合并OSAHS患者血清TNF-α和hs-CRP水平,同时记录各组睡眠呼吸暂停低通气指数(apnea-hypopnea index,AHI)。结果:ACI组、OSAHS组、ACI合并OSAHS组血清TNF-α、hs-CRP水平明显高于正常对照组(P<0.01);ACI合并OSAHS组血清TNF-α、hs-CRP水平明显高于ACI组(P<0.01),也明显高于OSAHS组(P<0.01)。OSAHS组、ACI合并OSAHS组AHI明显高于ACI组和正常对照组(P<0.01);ACI合并OSAHS组AHI明显高于OSAHS组(P<0.01)。结论:ACI及OSAHS患者均存在炎症反应,ACI合并OSAHS患者炎症反应的水平更高,OSAHS可能通过增强炎症级联反应的途径促进ACI的发生发展,通过抗炎治疗可能对ACI合并OSAHS患者预后有一定改善。

Objective To investigate the serum levels and clinical significance of tumor necrosis factor alpha（TNF-α） and high-sensitivity C-reactive protein（hs-CRP） in acute cerebral infarction（ACI） assosiated obstructive sleep apnea-hypopnea syndrome（OSAHS） patients.Methods The serum TNF-α and hs-CRP levels of 32 healthy people,36 patients with ACI,28 patients with OSAHS and 30 patients with ACI assosiated OSAHS were measured respectively by double antibody sandwich ELISA and latex enhanced immunoturbidimetric assay,while apnea-hypopnea index（AHI） was compared within each group.Results The serum levels of TNF-α and hs-CRP in ACI,OSAHS and ACI assosiated OSAHS were significantly higher than those in normal control group（P0.01）,the serum levels of TNF-α and hs-CRP in ACI assosiated OSAHS were evidently higher than those in both ACI and OSAHS（P0.01）,AHI in OSAHS and ACI assosiated OSAHS was notably higher than those in either ACI or normal control group（P0.01）,AHI in ACI assosiated OSAHS was obviously higher than those in OSAHS（P0.01）.Conclusion The inflammatory response exists in both ACI and OSAHS patients while the inflammatory response in ACI assosiated OSAHS patients was more prominent.OSAHS is likely to promote the development and evolution of ACI by enhancing the way of inflammatory cascade.Inhibiting the inflammatory response may improve the prognosis of ACI associated OASHS patients.