肝细胞生长因子在阻塞性睡眠呼吸暂停低通气综合征合并慢性阻塞性肺病的表达

Expression of hepatocyte growth factor in obstructive sleep apnea hypopnea syndrome with chronic obstructive pulmonary disease

目的肝细胞生长因子(hepatocyte growth factor,HGF)是潜在的肺泡细胞促有丝分裂因子,可促进损伤肺泡细胞的修复。文中旨在研究HGF血清表达水平和阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnoea hypopnoea syndrome,OSAHS)合并慢性阻塞性肺病(chronic obstructive pulmonary disease,COPD)患者缺氧程度的关系。方法采用酶联免疫吸附法(ELISA)测定单纯OSAHS组(n=32)、OSAHS合并COPD组(n=46)、对照组(n=30)血清HGF的水平,分析血清HGF水平与呼吸紊乱指数(apnea hypopnea index,AHI)、最低血氧饱和度(lowest SatO2,LSatO2)和COPD严重度的相关性。结果 OSAHS组、OSAHS合并COPD组血清HGF水平较健康对照组明显升高(P<0.05);OSAHS合并COPD组血清HGF水平明显高于OSAHS组(P<0.05);OSAHS亚组间比较,中度组与重度组血清HGF水平均较轻度组明显升高(P<0.05),重度组较中度组升高但差异无统计学意义(P>0.05);OSAHS合并COPD组间比较,重度COPD组较中度COPD组、轻度COPD组血清HGF水平均显著升高(P<0.05)。OSAHS组血清HGF水平与AHI正相关(r=0.387,P<0.05),与LSatO2负相关(r=-0.362,P<0.05)。结论 OSAHS患者、OSAHS合并COPD患者血清HGF水平升高,且HGF增高程度与OSAHS及COPD严重程度相关。HGF的表达与慢性缺氧成具有相关性。

Objective Hepatocyte growth factor （HGF） is a potent mitogenic factor for alveolar epithelial cells and may therefore improve alveolar epithelial repair in vitro and in vivo. The purpose of this study was to evaluate the relationship between the expression level of hepatocyte growth factor （HGF） of serum and anoxia degree in patients with obstructive sleep apnea hypopnea syn- drome and chronic obstructive pulmonary disease （overlap syndrome, OS）. Methods A total of 78 consecutive patients with ob- structive sleep apnea hypopnea syndrome （46 with COPD, 32 without COPD） and 30 health volunteer were enrolled in the study. Ser- um concentrations of HGF were measured with enzyme linked immnnosorbent assay （ELISA）, and the relationships between the serum HGF level and apnea hypopnea index （AHI） , lowest SatO2 （ LSatO2 ） were analyzed by linear correlation analysis. Results The ser- um HGF concentration was 685.46 _＋ 57.34 （pg/mL） in obstructive sleep apnea syndrome and 884.65 -＋ 58.32 （pg/mL） in OS, and 464.26 ＋ 50.31 （pg,/mL） in the controls, which was significantly higher in the OSAHS patients than the controls, and highest in the OSAHS patients with COPD （P 〈 0.05 ）. The serum HGF concentrations was positively related to AHI （r = 0.431, P 〈 O. 05 ） and neg- atively related to LSatO2 （r = -O. 289, P 〈 0.05 ） in the patients with OSAHS only, positively related to AHI, （r = O. 618, P 〈 0.01 ） and negatively related to LSatO2 （ r = - 0. 573, P 〈 O. 01 ） in the OSAHS patients with COPD. Conclusion Serum HGF eoncentra-tion increases significantly in patients with 0SAHS especially in OS, and positively correlates with the severity of OSAHS and COPD.