阻塞性睡眠呼吸暂停低通气综合征患者尿液中丙二醛变化及其意义

Change and significance of MDA in urine in obstructive sleep apnea syndrome

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAS)患者尿液中丙二醛(MDA)变化及其意义。方法收集40例OSAS患者和30名正常对照者睡眠监测患者的尿液、血液,测定尿液及血清中MDA的含量,并与睡眠监测指标进行相关性分析。结果 OSAS组尿液中MDA比正常对照组升高,分别为(7.93±1.39)μmol/L,(5.43±1.21)μmol/L(P<0.01);OSAS组血液中MDA比正常对照组升高,分别为(5.59±1.28)μmol/L,(4.16±1.08)μmol/L(P<0.01);OSAS患者尿液中MDA与血清MDA呈正相关(r=0.675,P<0.01),与AHI正相关(r=0.670,P<0.05),与睡眠中最低血氧饱和度和平均血氧饱和度呈负相关(r=0.606、-0.442、-0.454,P值均<0.05)。结论 OSAS患者存在夜间氧化应激反应增强,OSAS患者尿液中MDA可以作为评价患者氧化应激状态和估计病情严重程度的较好指标。

Objective To study the changes of MDA in exhaled urine in patients of obstructive sleep apnea syndrome（OSAS） and discuss their clinic significance. Methods Forty OSAS patients and 30 normal controls were included in the study.Urine and serum after PSG were collected. The levels MDA were detected and compared between the primary group and OSAS patients, the correlation between MDA and PSG parameters were further evaluated using correlation analysis. Results The urine level of MDA was significantly higher in OSAS patients than that normal controls, （7.93 ± 1.39） μmol/L VS（5.43 ± 1.21） μmol/L, （P〈0.01）. The serum level of MDA was significantly higher in OSAS patients than that normal controls, （5.59 ± 1.28） μmol/L VS （4.16 ± 1.08）μmol/L）（P〈0.01）.The concentration of MDA in urine of OSAS patients was correlated positively with serum MDA level（r=-0.675, P〈0.01）.The concentration of MDA in urine of OSAS patients was correlated positively with AHI（r=-0.606, P〈0.05）and negatively with the lowest SaO2 and the mean SaO2（r=--0.442, -0.454, P〈0.05）. Conclusion These findings suggest that oxidative stress is characteristic in OSAS patients.The level of MDA in urine depends on the severity of the OSAS and may prove to be usefuI in monitoring of airway oxidative stress of OSAS.