阻塞性睡眠呼吸暂停低通气综合征患者手术前后血中CRP、TNF-α、IL-8的变化

Level changes of C-reactive protein,tumor necrosis factor-alpha and interleukin-8 in patients with obstructive sleep apnea hypopnea syndrome before and after operation

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者手术前后血中C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)水平的变化。方法选取67例经多导睡眠监测仪(PSG)证实的重度OS-AHS患者作为研究组,同时以30例与研究对象相匹配的健康人群做对照。用放射免疫法检测血清中TNF-α及IL-8,用乳胶增强免疫比浊法检测血清中CRP。结果术前OSAHS组血清CRP〔(7.01±0.33)mg/L〕、TNF-α〔(1.82±0.36)μg/L〕、IL-8〔(227.18±88.17)ng/L〕水平明显高于对照组〔(2.87±0.21)mg/L、(0.99±0.31)μg/L、(153.23±62.11)ng/L〕(P均<0.05);术后OSAHS组血清CRP〔(3.27±0.33)mg/L〕、TNF-α〔(1.11±0.27)μg/L〕、IL-8〔(149.73±66.12)ng/L〕水平较术前明显下降(P均<0.05),与对照组水平比较差异无统计学意义(P均>0.05)。结论 OSAHS患者术前血清中CRP、TNF-α、IL-8水平失衡,经过鼻持续正压通气及手术治疗后,3种因子水平可下降至正常水平。CRP、TNF-α及IL-8可做为OSAHS诊治的有效指标。

Objective To probe the level changes of C-reactive protein（CRP）,tumor necrosis factor-alpha（TNF-α） and interleukin-8（IL-8） in patients with obstructive sleep apnea hypopnea syndrome（OSAHS） before and after operation.Methods Sixty seven patients with serious OSAHS confirmed by ploysomnography（PSG） were selected as research group,and 30 cases with healthy body were served as control group,which had the similar basal materials with research group.The serum levels of TNF-αand IL-8 were detected by radioimmune method,and the levels of CRP were detected through latex-enhanced immunoturbidimetry.Results The levels of CRP,TNF-αand IL-8 before operation in research group were（7.01±0.33） mg/L,（1.82±0.36） μg/L and（227.18±88.17） ng/L,respectively,which were higher than those〔（2.87±0.21） mg/L,（0.99±0.31） μg/L and（153.23±62.11） ng/L〕 in control group（all P〈0.05）.The levels of CRP,TNF-αand IL-8 after operation in research group were（3.27±0.33） mg/L,（1.11±0.27） μg/L and（149.73±66.12） ng/L,respectively,which were obviously lower than those before operation（all P〈0.05）,and had no statistical difference compared with those in control group（all P〉0.05）.Conclusions The serum levels of CRP,TNF-αand IL-8 in patients with OSAHS before operation are out of balance,but they could decrease to normal levels after treated by nasal continuous positive airway pressure and operation.CRP,TNF-α and IL-8 in serum could served as effectiveness indexes for making a diagnosis and giving treatment of OSAHS.