阻塞性睡眠呼吸暂停低通气综合征患者免疫功能的损伤及相关机制

Damages and mechanism of immunological function in patients with obstructive sleep apnea hypopnea syndrome

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)"缺氧-复氧"对患者免疫功能的影响及相关机制。方法前瞻性研究187名确诊阻塞性睡眠呼吸暂停低通气综合征的患者并以30名体检健康者作为对照,所有患者的病历资料均采用统一标准的方案记录,包括记录整晚睡眠监测、体液免疫、细胞免疫结果。结果 OSAHS与正常健康对照组比较,体液免疫中C3明显升高,IgM有下降趋势,细胞免疫中NK细胞所占T淋巴细胞的百分率明显下降,差异均有统计学意义(P<0.01);相关性分析示C3与呼吸暂停低通气指数(AHI)呈正相关、与经皮最低血氧饱和度(LSpO2)负相关;IgM与LSpO2弱正相关;NK细胞与AHI弱负相关;其他项免疫功能指标在统计学上无显著相关性。结论阻塞性睡眠呼吸暂停低通气综合征患者存在免疫功能的损害,可能存在免疫功能的下降。

Objective To determine whether there was any damage in the immunological function of hypoxia-reoxygenation in obstructive sleep apnea hypopnea syndrome （OSAHS） patients caused by hypoxia-reoxygenation and relative mechanism. Methods We carried out a prospective cross-sectional study of 187 patients diagnosed for OSAHS and 30 healthy people for control group. For all patients, a medical history was taken using a standardized protocol, involving the results of an overnight sleep study and humoral and cellular immunity of venous blood. Results It was found that an obvious increase on the levels of C3 and decrease both on level of IgM and the percentage of NK cells account for T lymphoeytes in OSAHS patients when comparing with the control group, and the difference was significant（P 〈 0.01 ）. Correlation showed that C3 had a positive correlation with AHI, but a negative with lowest pulse oxygen saturation （ LSpO2 ） ; Also, IgM a mild positive correlation with LSpO2 and NK ceils a mild negative correlation with AHI. The rest of immunological function was not found noticeable change and any correlation. Conclusions From the above, we can draw a conclusion that there were some changes on the functions of immunology of OSAHS and there maybe was a descent on the immunological function of OSAHS including humoral and cellular immunity.