SAS患者细胞因子与心血管疾病相关性研究

A Study of Correlation Between Cytokine Levels and Cardiovascular Diseases in Patients With Sleep Apnea

目的 通过对睡眠呼吸暂停综合症 (SAS)伴有心血管并发症患者血浆肿瘤坏死因子 (TNF -α)、内皮素 (ET - 1)、白细胞介素 6 (IL - 6 )的检测 ,讨论其与心血管并发症之间的相关性。方法 包括 15例伴有高血压、心绞痛、心率失常的SAS患者及 15例无心脑血管疾病的正常人 (对照组 )且年龄、性别、身高及体重相匹配。采用ELISA法检测两组的TNF -α、ET - 1、IT - 6的水平及治疗前后的改变。结果 SAS组与对照组比较TNF -α、ET - 1及IL - 6水平均升高 (P <0 0 1及 0 0 5 ) ,比较差异有显著性 ,经过nCPAC治疗一月以后均有明显改善 (P<0 0 5 ) ;血浆ET - 1与呼吸暂停指数 (AI)及平均动脉压 (MAP)呈正相关 (γ =0 5 1,0 36 ) ;IL - 6和TNF -α与LSaO2 呈负相关 (γ =- 0 4 8及 0 4 6 ,P <0 0 1)。结论 SAS患者血浆细胞因子异常可能是因夜间反复的低氧血症和神经内分泌异常所至 ,并参与心血管疾病的发生与发展。治疗SAS可减少心血管事件的发生。

Objective Exploring the relationship among plasma tumor necrosis factor alpha(TNF-α),endothelin-1(ET-1),interleukin-6(IL-6) and cardiovascular diseases in patients with sleep apnea.Methods ELISA method were used to measure circulating levels of TNF-α,ET-1 and IL-6 in 15 with SAS complicated with cardiovascular diseases and 15 normal subjects, matched in the age ,sex ,height and weight.Results Plasma TNF-α,ET-1 and IL-6 level had increased significantly in SAS group,as compared with normal subjects(P<0 05 and 0 01),and had decreased significantly after 1 month of continuous nCPAP therapy(P<0 05). Plasma ET-1 levels and apnea index(AI) and mean arterial pressure(MAP) were positive correlated (γ=0 51,0 36) ;Plasma TNF-α,IL-6 and the lowest oxygen saturation(LSaO 2) were negative correlated (γ=-0 46,-0 48).Conclutions SAS-induced intermittent nocturnal hypoxemia and neuroendocrine disorder could lead to abnormality of plasma cytokines,these abnormal cytokines resulting in the development of cardiovascular disorders. Treatment of SAS can be a potential approach to prevention of cardiovascular events.