阻塞性睡眠呼吸暂停低通气综合征患者血清白三烯B4水平的研究

Study of leukotriene B4 in patients with obstructive sleep apnea-hypopnea syndrome

目的研究不同程度OSAHS患者血清白三烯B4（leukotriene B4，LTB4）的水平，探讨OSAHS患者发生心血管疾病的可能机制。方法经多导睡眠图（polysomnography，PSG）监测确诊为OSAHS患者48例，根据呼吸暂停低通气指数（apnea-hypopnea index，AHI）分为轻、中、重3组，行PSG筛查除外OSAHS者12例，作为正常对照组，各组均于PSG监测后采空腹静脉血，应用酶联免疫吸附法（enzyme-linked immunosorbent assay，ELIA）检测血清LTB4水平。结果①与对照组比较，中、重度OSAHS组血清LTB4水平升高，差异有统计学意义（P值均〈0．05）；轻度OSAHS组与对照组比较差异无统计学意义（P〉0.05）。②OSAHS患者血清LTB4水平与AHI、氧减指数（oxygen desaturation index，ODI）、血氧饱和度小于0．9时间占睡眠时间百分比（percentage of time spend when oxygensaturation lower than 0．9，SLT90％）、最长呼吸暂停时间（longest apnea time，LAT）呈显著正相关（r值分别0．582、0．516、0．577、0．577，P值均〈0．01），与夜间最低血氧饱和度（minimal satuation of blood oxygen，SaO2 min）呈显著负相关（r=-0．620，P〈0．01）。③多元逐步回归结果显示，SaO2 min是影响OSAHS患者血清LTB4水平的独立危险因素（R^2=0．385，P〈0．01）。结论OSHAS患者血清LTB4水平明显升高，缺氧严重程度与OSHAS患者血清LTB4水平密切相关。

Objective To investigate the level of serum leukotriene B4 （LTB4） in patients with different severity in obstructive sleep apnea-hypopnea syndrome （OSAHS）, and to explore the probable mechanisms of cardiovascular diseases in patients with OSAHS. Methods Forty-eight subjects, who were diagnosed as OSAHS by PSG, were studied. Those patients were divided into three groups （mild, moderate, severe） according to AHI. Another 12 healthy individuals were as a control group. The fasting venous bloods were obtained after PSG for all subjects. The concentrations of serum LTB4 were measured by ELISA. Results ①The level of serum LTB4 in moderate and severe OSAHS group was higher than that in control group （all P〈0.05）. There was no significant difference between mild OSAHS group and control group （ P 〉 0.05）. ② The level of serum LTB4 was positively correlated with AHI, ODI, SLT90% and LAT （ r = 0. 582, 0. 516, 0. 577 and 0. 577 respectively, all P 〈 0.01 ）, and was negatively correlated with SaO2 rain （ r= 0. 620, P d0.01）. ③Multiple regression analysis showed that the level of SaO2 rain was the independent risk factor to influence the level of serum LTB4 in patients with OSAHS （R^2 =0. 385, P 〈0.01）.Conclusions The level of serum LTB4 was significantly increased. It suggested that the level of serum LTB4 was closely related with severity of hypoxia in patients with OSAHS.