OSAHS患者综合治疗对血清sTNF-RⅠ水平的影响

Eeffct of multimodality therapies on plasma solube tumor necrosis factor receptorⅠin OSAHS patients

目的:了解OSAHS患者血清可溶性肿瘤坏死因子受体-Ⅰ(sTNF-RⅠ)的水平,评估OSAHS患者综合治疗对血清sTNF-RⅠ水平的影响。方法:选择62例经多导睡眠监测仪诊断的OSAHS患者为实验组,15例非OSAHS患者为对照组。选取中重度组患者进行治疗前和治疗3个月后做前后对照比较,用酶联免疫吸附实验(ELISA)方法检测非OSAHS患者及OSAHS患者基础水平以及中重度组综合治疗前后血清sTNF-RⅠ水平。结果:①实验组血清sTNF-RⅠ水平(742±258pg/ml)较对照组(340±102pg/ml)明显升高(P<0.05);②中重度OSAHS治疗组患者血清sTNF-RⅠ水平(351.4±116.9pg/ml)较治疗前(834.1±233.8pg/ml)明显降低(P<0.05);③控制体重、年龄、体质指数、性别等混杂因素后血清sTNF-RⅠ水平与AHI呈正相关(r=0.646,P<0.01),与夜间最低氧饱和度呈负相关(r=-0.522,P<0.01)。结论:在控制体重、年龄、体质指数等混杂因素后,OSAHS患者严重程度与血清sTNF-RⅠ有一定的相关性,综合治疗可以降低OSAHS患者血清sTNF-RⅠ水平。

Objective： As a subtype membrane receptor of tumor necrosis factor-a,not much is known about the link between the soluble TNF receptor- I and obstructive sleep apnea hypopnea syndrome. We hypothesized that the TNF receptor might play an important role in the inflammation in patients with OSAHS, moreover this study was undertakan to investigate the effects of multimodality therapies on its periphery blood level. Method： Seventy-seven adults with habitual snoring and mean age of 34.9 ± 11 years old consented to participate in the study. All participants were studied with overnight polysomnography, physical examination and a blood crew at baseline. According to the severity of OSAHS, they were categorized into three groups and one control group. Moderate and severe OSAHS groups returned for a repeat test of potysomnography and a blood crew at 3 months after the ENT surgery or continuous positive airway pressure（CPAP）, serum levels were measured by using an immunoluminometric assay kit. Result： （1）Compared with control non-OSAHS group, serum sTNF-R I levels prior to treatment in OSAHS groups were significantly greater, with a mean serum levels at（742 ± 258 ＆ 340 ± 102）pg/ml （P〈0.05）,respectively. （2）Plasma solube tumor necrosis factor receptor-I responsed sensitively to the effect of comprehensive therapies when we compared its prior treatment levels with post ones. （3）Analysis was used to assess the associations adjusting for age, gender, BMI and weight ,a positive assosiation were found between apneahypopnea index（AHI） and sTNF-R I （r= 0. 646, P〈0.01） a negative assosiation were found between lowest nadir oxygen saturation（LSaO2）and（r= -0.522,P〈0.01）. Conclusion：In summary, independent of age, gender, BMI and weight ,our datas suggest a relationship can be found between the the severity of OSAHS and periphery blood level of soluble TNF receptor- I . Comprehensive therapies is effective in changing sTNF-R I. sTNF-R I may be recommended as a Inflammation factor of OSAHS.