阻塞性睡眠呼吸暂停低通气综合征患者情绪与血浆5-羟色胺水平关系研究

Relationship between Emotion and Serum Level of 5- Hydroxytryptamine in Patients with Obstructive Sleep Apnea Hypopnea Syndrome

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者情绪与血浆5-羟色胺(5-HT)水平的关系。方法选取2010年6月—2013年6月河北联合大学附属医院呼吸科确诊的OSAHS患者121例为OSAHS组,另选择本院同期体检的健康人群60例为对照组,采用焦虑自评量表(SAS)判断有无焦虑,应用心境状态量表(POMS)评估情绪状态,采用酶联免疫吸附法(ELISA)测定血浆5-HT水平。结果 OSAHS组POMS评分中紧张-焦虑、忧郁-沮丧、疲惫-惰性评分高于对照组,活力-好动评分低于对照组(P<0.05);OSAHS组血浆5-HT水平高于对照组(P<0.05)。OSAHS程度与SAS评分呈正相关(r=0.642,P=0.000);与POMS评分中紧张-焦虑、忧郁-沮丧、疲惫-惰性评分呈正相关(r=0.515,P=0.000;r=0.526,P=0.000;r=0.318,P=0.018);与活力-好动评分呈负相关(r=-0.496,P=0.000)。OSAHS病程与SAS评分呈正相关(r=0.489,P=0.001);与POMS评分中紧张-焦虑、忧郁-沮丧、疲惫-惰性评分呈正相关(r=0.509,P=0.000;r=0.371,P=0.010;r=0.271,P=0.021);与活力-好动评分呈负相关(r=-0.474,P=0.000)。OSAHS组63例出现焦虑,发生率为52.1%;OSAHS患者焦虑组POMS评分中紧张-焦虑、忧郁-沮丧、疲惫-惰性评分高于非焦虑组,活力-好动评分低于非焦虑组(P<0.05);焦虑组血浆5-HT水平高于非焦虑组(P<0.05)。OSAHS患者血浆5-HT水平与SAS评分呈正相关(r=0.689,P=0.000);与POMS评分中紧张-焦虑、忧郁-沮丧评分呈正相关(r=0.522,P=0.000;r=0.548,P=0.000),与活力-好动评分呈负相关(r=-0.508,P=0.000)。结论 OSAHS患者可呈现不同的负性情绪,伴有血浆5-HT水平的升高;OSAHS患者的焦虑情绪变化与5-HT变化水平有关。

Objective To investigate the relationship between emotion and serum level of 5- hydroxytryptamine（ 5-HT） in patients with obstructive sleep apnea hypopnea syndrome（ OSAHS）. Methods 121 patients who were diagnosed with OSAHS by Department of Resiratory,the Hospital Affiliated to Hebei United University from June 2010 to June 2013,were selected as OSAHS group. 60 healthy physical examinees in the same hospital over that period were selected as control group. The anxiety disorder was evaluated by self- rating anxiety scale（ SAS）,mood state was evaluated by profile of mood states（ POMS）,the serum level of 5- HT was determined by ELISA. Results The POMS scores for tension- anxiety,depression- dejection and fatigue- interia in the OSAHS group were significantly higher than those in the control group,while the POMS score for vigor-activity in the OSAHS group was significantly lower than that in control group（ P〈 0. 05）; the serum level of 5- HT in the OSAHS group was significantly higher than that in control group（ P〈 0. 05）. There was positive correlation between the total scores of SAS and the degree of OSAHS（ r = 0. 642,P = 0. 000）,and there was positive correlation between the degree of OSAHS and the POMS scores of tension- anxiety,depression- dejection,fatigue- interia（ r = 0. 515,P = 0. 000; r = 0. 526,P = 0. 000; r = 0. 318,P = 0. 018）. There was negative correlation between the degree of OSAHS and the POMS score of vigor- activity（ r =- 0. 496,P = 0. 000）. There was positive correlation between the total scores of SAS and the course of OSAHS（ r =0. 489,P =0.001）. There was positive correlation between the course of OSAHS and the POMS scores of tension-anxiety,depression- dejection,fatigue- interia（ r = 0. 509,P = 0. 000; r = 0. 371,P = 0. 010; r = 0. 271,P = 0. 021）. There was negative correlation between the course of OSAHS and the POMS score of vigor- activity（ r =- 0. 474,P = 0. 000）. 63 cases in OSAHS group had symptoms of anxiety,the prevalence was 52. 1%. Among patients with OSAHS,the POMS scores of tension-anxiety,depression- dejection and fatigue- interia in the anxiety group were significantly higher than those in the non- anxiety group,while the POMS score of vigor- activity in the anxiety group was significantly lower than that in the non- anxiety group（ P〈 0. 05）,and the serum level of 5-HT in the anxiety group was significantly higher than that in the non-anxiety group（ P〈 0. 05）. There was positive correlation between the serum level of 5- HT and the score of SAS among patients with OSAHS（ r= 0. 689,P = 0. 000）,while there was positive correlation between the serum level of 5- HT and the POMS scores of tension-anxiety,depression- dejection（ r = 0. 522,P = 0. 000; r = 0. 548,P = 0. 000）,and there was negative correlation between the serum level of 5- HT and the POMS score of vigor- activity（ r =- 0. 508,P = 0. 000）. Conclusion Patients with OSAHS are prone to have different negative emotions,and negative emotions were usually accompanied by elevation of plasma level of 5- HT,and the change of anxiety is related to the change of plasma level of 5- HT.