持续气道正压通气和N-乙酰半胱氨酸治疗对OSAHS患者血清基质金属蛋白酶-2水平的影响

Influence of continuous positive airway pressure ventilation and N-acetylcysteine on the levels of serum matrix metalloproteinase-2 in patients with OSAHS

目的探讨血清基质金属蛋白酶-2(MMP-2)与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)发病的关系,持续气道正压(CPAP)通气和N-乙酰半胱氨酸(NAC)治疗对血清MMP-2水平的影响。方法利用酶联免疫吸附法对30例轻度OS-AHS患者(轻度OSAHS组)、68例中重度OSAHS患者(中重度OSAHS组)和22名健康者(正常对照组)血清中MMP-2的水平进行检测;对其中40例中重度OSAHS患者进行CPAP治疗,20例中重度OSAHS患者口服NAC治疗,1月后复测其血清MMP-2的水平。结果①与正常对照组相比,OSAHS患者血清中MMP-2的水平增高(F=3.756,P=0.021);②40例中重度OSAHS患者在CPAP治疗后和20例中重度OSAHS患者在口服NAC后血清中MMP-2的水平均明显下降,差异具有统计学意义(t=2.369、2.116,P均<0.05)。结论 OSAHS患者血清中MMP-2水平升高,与OSAHS的发病可能相关;CPAP和NAC治疗可使OSAHS患者血清MMP-2水平下降。

Objective To explore the relationship between serum matrix metallopmteinase-2 （MMP-2） and obstructive sleep ap- nea hypopnea syndrome （OSAHS） and the influence of continuous positive airway pressure （CPAP） ventilation and N-acetylcysteine （NAC） on the levels of serum MMP-2. Methods The study selected 30 patients with mild OSAHS as the mild OSAHS group, 68 pa- tients with middle-severe OSAHS as the middle-severe OSAHS group, and 22 healthy adults as the control group, and their levels of serum MMP-2 were detected by ELISA. 40 patients with middle-severe OSAHS were treated with CPAP ventilation and another 20 patients were taken NAC treatment. The level of serum MMP-2 was detected 1 month the treatment. Results ① The level of serum MMP-2 was signifi- cantly higher in the two OSAHS groups than in the control group （ F = 3. 756, P = 0. 021 ）. ② The level of serum MMP-2 decreased sig- nificantly in the 40 middle-severe OSAHS patients and the 20 middle-severe OSAHS patients 1 month after the treatment with statistical significance （ t = 2. 369, 2. 512, P 〈 0. 05 ）. Conclusion The high level of serum MMP-2 in patients with OSAHS may be involved in the occurrence of OSAHS, and CPAP and the therapy of NAC can decrease the MMP-2 level.