止鼾枕对阻塞性睡眠呼吸暂停低通气综合征患者微觉醒、AHI以及血清中Th1、Th2细胞的影响

Effect of anti-snore pillow on microarousal,AHI and Th1,Th2 cells in patients with obstructive sleep apnea-hypopean syndrome

目的探讨止鼾枕对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者微觉醒、AHI以及Th1、Th2细胞的影响。方法将本院门诊或住院处就诊的41例OSAHS患者和17例单纯打鼾患者纳入本研究。本研究分为3组,分别为对照组(单纯打鼾患者)17例、OSAHS组(未经止鼾枕矫正)19例和OSAHS+止鼾枕矫正组(经止鼾枕矫正2周)22例。采用多导睡眠监测患者整晚的睡眠情况,记录患者的微觉醒次数和睡眠呼吸暂停低通气指数(AHI),运用流式细胞仪测定Th1和Th2细胞所占的比例。结果 3组受试者的年龄、性别比例以及BMI均无统计学差异(P>0.05)。与对照组相比,OSAHS组患者的微觉醒次数显著增加(P<0.05),AHI指数显著升高(P<0.05),Th1细胞所占比例也大幅提升(P<0.05),而Th2细胞所占比例则显著下降(P<0.05)。与OSAHS组相比,OSAHS+止鼾枕组患者的微觉醒次数、AHI和Th1细胞所占比例均显著降低(P<0.05)。结论 OSAHS患者微觉醒次数和AHI显著升高,体内Th1/Th2的平衡发生偏移,止鼾枕可以降低微觉醒次数和AHI的升高,并在一定程度上恢复Th1/Th2的动态平衡。

Objective To investigate the effect of anti-snore pillow on microarousal,apnea hyponea index（ AHI） and Th1,Th2 cells in patients with obstructive sleep apnea-hypopean syndrome（ OSAHS）. Methods Forty one severe OSAHS patients and 17 simple snorers were selected.All the patients were divided into control group（ simple snorers,n = 17）,OSAHS group（ had not received treatment of anti-snore pillow,n = 19） and OSAHS plus anti-snore pillow group（ had received treatment of anti-snore pillow for 2 weeks,n = 22）. The numbers of microarousal and AHI were evaluated by polygraph,while the proportion of Th1 and Th2 cells were detected by flow cytometry. Results There were no significant differences of BMI,gender and age among the 3 groups（ P〉 0. 05）.Compared with control group,numbers of microarousal and AHI in OSAHS group increased significantly（ P〈 0. 05）. The proportion of Th1 significantly increased（ P〈 0. 05） while the proportion of Th2 decreased significantly（ P〈 0. 05）. Compared with OSAHS group,the numbers of microarousal,AHI and the proportion of Th1 decreased significantly in OSAHS plus anti-snore pillow group（ P〈 0. 05）. Conclusion The numbers of microarousal and AHI increase in OSAHS patients,and the balance of Th1 / Th2 is disturbed. Anti-snore pillow can reduce the numbers of microarousal and AHI,and restore dynamic balance of Th1 / Th2.