帕金森病伴OSAHS患者血清胱抑素C水平的临床研究

The Expression Meaning of Serum Cysc in Parkinson's Patients With Obstructive Sleep Apnea-Hypopnea Syndrome

目的探讨血清胱抑素C在帕金森病合并阻塞性睡眠呼吸暂停低通气综合征患者中表达水平的临床意义。方法选取2012年5月-2014年5月期间在某院呼吸内科就诊并完成多导睡眠监测的帕金森患者109例为研究对象,根据AHI将所有患者分成2组:帕金森病组51例和OSAHS合并帕金森病组58例。另选取同期检查的健康中老年人40名作为对照组。记录相关临床资料,检测所有研究对象生化指标、睡眠参数、运动功能以及Cys C水平,计量资料采用方差分析和两独立样本t检验;计数资料采用χ2检验,P<0.05说明差异具有统计学意义。结果帕金森病组患者的Cys C水平为(0.98±0.10)mg/L,OSAHS合并帕金森病组为(1.07±0.15)mg/L,对照组为(0.86±0.18)mg/L,三组间的比较差异有统计学意义(F=9.184,P=0.001);Cys C水平与氧减饱和度指数、血氧小于90%时间占睡眠总时间比例、AHI、呼吸相关微觉醒指数及H-Y分级呈正相关(r值分别为0.572、0.435、0.762、0.391、0.683,P值均<0.05)。将Cys C作为因变量,行线性回归提示AHI(B=0.051,P=0.012)、H-Y分级(B=0.113,P=0.024)是Cys C水平变化的重要影响因素。结论帕金森病患者Cys C水平升高,而OSAHS合并帕金森病的患者Cys C水平更高,其水平的高低与睡眠呼吸紊乱程度和帕金森病的严重程度有关。

Objective To explore the expression meaning of serum Cystatin C（Cys C） in patients with Parkinson and Obstructive Sleep Apnea-Hypopnea Syndrome（OSAHS）. Methods 109 patients with PD who were finished polysomnography examination from May 2012 to May 2014 in the respiratory department in our hospital were divided into two groups according to the AHI ： 51 cases in PD group and 58 cases in PD with OSAHS group,and another 40 health subjects who had taken the polysomnography examination during the same time were chosen as the control group. All the general situation, the biochemical indicators, sleep parameters, movement function and Cys C level were checked and compared. Results The serum levels of Cys C in the patients of PD group were（0.98±0.10mg/L）,PD with OSAHS group were（1.07±0.15mg/L and control group were（0.86±0.18mg/L）, the differences between three groups was statistically significant（F=9.184,P=0.001）; Cys C level with oxygen desaturation index,the proportion of less than 90% blood oxygen satuation, AHI, the arousal index and Hoehn-Yahr（H-Y） stage were positively correlated（r = 0.572, 0.435, 0.762, 0.391, 0.683, respectively, all P〈0.05）. Cys C as dependent variable, the linear regression suggests AHI（B = 0.051, P = 0.051） and H-Y stage（B = 0.113, P = 0.113） is one of the important factors affecting the Cys C level changes. Conclusion The Cys C level of the patients with PD were increased significantly, and increased more higher of the patients with PD and OSAHS, all the phenomenon shows that the degree of sleep-disordered breathing and the severity of PD were relatived to Cys C levels.