阻塞性睡眠呼吸暂停患者悬雍垂腭咽成形术后氧化应激水平变化

The Changes of Oxidative Stress Level in Patients with Obstructive Sleep Apnea Syndrome after Uvulopalatopharyngoplasty

目的探讨阻塞性睡眠呼吸暂停低通气综合征患者行悬雍垂腭咽成形术后1年治疗后氧化应激水平变化。方法经多导睡眠图监测确诊为阻塞性睡眠呼吸暂停低通气综合征患者67例(男47例,女20例),中位年龄41(20-58)岁。正常对照组(AHI<5)44例(男32例,女12例),中位年龄42(18-59)岁。全部阻塞性睡眠呼吸暂停低通气综合征患者接受悬雍垂腭咽成形术手术治疗,于术前及术后1年检测睡眠监测指标(AHI、SLT90%、LAT、ODI及Sa O2min)及氧化应激指标(SOD、MDA)。结果与对照组比较,OSAHS组血清MDA水平增高,血清SOD水平减低,差异有统计学意义(P值均<0.05)。悬雍垂腭咽成形术手术后1年AHI、ODI、LAT、SLT90%下降及Sa O2min升高,而血清MDA、SOD水平与术前比较无统计学差异(P值均>0.05)。结论阻塞性睡眠呼吸暂停低通气综合征患者存在氧化应激反应。悬雍垂腭咽成形术手术治疗可一定程度改善缺氧,但不能改善氧化应激反应,手术后仍可能需要辅助持续气道正压通气治疗。

Objectives To investigate the changes of the oxidative stress level in patients with obstructive sleep apnea syndrome（OSAS） after one year by uvulopalatopharyngoplasty（UPPP）. Methods 67 cases of patients who were diagnosed by polysomnography（PSG） as OSAS were selected in this study. in which there were 47 men and 20 women,the median age was 41（20-58） years old,44 cases of selected as control group（AHI〈5）. in which there were 32 men and 12 women,the median age was 42（18-59）years old. All patients with OSAS were accepted UPPP,and the sleep monitoring indexes included AHI,SLT90%,LAT,ODI,Sa O2 min. SOD and MDA were compared before and one year after the operation. Results The level of serum MDA was significantly higher than that in control group. The concentration of serum SOD in OSAS group was significantly lower than that in control group（P〈0.05）. The parameters including AHI,SLT90%,LAT,ODI,and Sa O2 min were significantly improved after 12 months by UPPP therapy. while there were no significant difference among serum SOD and MDA in patients with OSAS who were accepted UPPP（P〉0.05）. Conclusions Oxidative stress reaction is existed in the patients with obstructive sleep apnea syndrome. Although improved hypoxia some degree. UPPP couldn＇t rectify oxidative stress disorder completely in patients with OSAS. so the OSAS patients should be received CPAP therapy after UPPP.