阻塞性睡眠呼吸暂停低通气综合征患者血清热休克蛋白70及氧化应激指标检测

Detection of serum heat shock protein 70 and indexes of oxidative stress in patients with obstructive sleep apnea-hypopnea syndrome

目的了解阻塞性睡眠呼吸暂低通气停综合征(OSAHS)患者血清热休克蛋白70(HSP70)的水平以及氧化应激反应对其的影响,探讨HSP70在OSASH疾病过程中的作用。方法对7 9例OSAHS患者实施等离子辅助下悬雍垂腭咽成形术,于术前及术后6个月检测血清中HSP7 0、超氧物歧化酶(SOD)、丙二醛(MDA)水平,分析手术前后HSP70水平变化以及与AHI、MDA、SOD之间的关系。同期选取20例单纯打鼾患者作为对照组。结果 OSAHS患者血清中HSP70、MDA水平较正常对照组显著增高(P<0.01),HSP70与AHI、MDA呈正相关(r=0.95,P<0.01;r=0.61,P<0.01);血清SOD活性降低,与HSP70无关联;术后有效者HSP70水平降低恢复正常水平,无效者手术前后差异无统计学意义(P>0.05)。结论 OSAHS患者存在热休克反应,血清HSP70水平增高,此表达与OSAHS病情及体内的氧化反应程度有关,HSP70在OSASH的病理过程中可能发挥保护性作用。

Objective To explore the significance of heat shock protein 70 （HSP70） and the effect of oxidative stress in patients with obstructive sleep apnea-hypopnea syndrome （ OSAHS ）. Methods A total of 79 patients with OSAHS and 20 normal controls were enrolled in this study. All OSAHS patients received modified coblatiun-assisted uvulopalatopharyngoplasty （UPPP）. Morning venous blood samples were collected from all cases before surgery and from OSAHS patients 6 months after. The serum levels of HSP70, superoxide dismutase （ SOD ） were detected with enzyme-linked immunosorbent assay （ELISA）, methylene dioxyamphetamine （MDA） with thibabituric acid method respectively. Correlations between HSP70 level and AHI, MDA were analyzed. Results Serum levels of HSP70 and MDA in OSAHS group were significantly higher than those in the control group （ P 〈 0. O1 ）. Serum I-ISP70 level was positively correlated with those of AHI and MDA respectively （r =0.95, P 〈0.01 ; r = 0.61, P 〈 0.01 ）, but insignificantly correlated with that of SOD. 6 months after surgery, HSP70 levels in the cases with good clinical effect decreased to control （ P 〈 0.01 ） , while those in the patients no clinical effect kept unchanged （P 〉0.05）. Conclusion Heat shock response exists in OSAHS patients. The increased HSP70 level is associated with the state of OASHA and degree of oxidative stress. HSP70 may participate in the protective mechanism in OSAHS.