OSAHS患者血清胰岛素样生长因子-1水平变化与心功能的关系

Relationship between change of level of serum insulin-like growth factor-1 and cardiac function in patients with obstructive sleep apnea hypopnea syndrome

目的探讨OSAHS患者血清IGF-1与左心功能间的关系。方法受试者行PSG检测;血清IGF-1检测;超声心动图测量左室结构和功能。结果 OSAHS轻中重度组与对照组间AHI、最低SpO2、平均SpO2均有差异(P均<0.05);轻中重度组与对照组比较,左室扩张(P均<0.05);重度组与轻中度组、对照组比较,左房扩张(P均<0.05);重度组与轻度组、对照组比较左室收缩与舒张功能降低(P均<0.05);中重度组血清IGF-1均低于对照组、轻度组(P均<0.05);相关分析显示OSAHS组IGF-1与AHI呈负相关(r=-0.620,P<0.05),与最低SpO2、平均SpO2呈正相关(r=0.604,r=0.448,P均<0.05);重度组IGF-1与LVEF呈正相关(r=0.709,P<0.05)。结论 OSAHS患者存在左心功能不全,并与OSAHS的严重程度相关。OSAHS患者血清IGF-1降低,可能是OSAHS左心功能不全的生化机制之一。

Objective To discuss the relationship between the level change of serum insulin-like growth factor-1 （IGF-1） and cardiac function in patients with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods The study selected 73 patients with OSAHS as the observation group and 31 cases without OSAHS as the control group. They were all given polysomnography （PSG） and eeh- ocardiography to detect serum IGF-I level and left ventricular structure and function. Results There were significant differences on the levels of AHI, and the lowest and mean SpO2 among the control group, and the light, moderate and severe groups （P 〈0.05 ）. The left ventricle dilated more obviously in the observation group than in the control group （ P 〈 0.05 ） , and the left atrium dilated more obviously in the severe group than in the light and moderate groups and the control group （ P〈 0.05 ）. The level of IGF-1 was obviously lower in the moderate and severe groups than in the light group and the control group （ P 〈0.05 ）. The results showed that the level of IGF-1 was negatively correlated with AHI and positively correlated with the lowest and mean levels of SaO2 in the observation group. Besides, the level of IGF-I was positively correlated with LVEF （ r = 0. 709, P 〈 0.05 ）. Conclusion The level of serum IGF-1 and left ventricular function in patients with OSAHS are decreased, and the decrease of serum IGF-1 may play an important role in the process of left ventrieular dysfunction in patients with OSAHS. [ Key words] obstructive sleep apnea-hypopnea syndrome; Insulin-like growth factor-1; congestive heart failure