阻塞性睡眠呼吸暂停低通气综合征患者血清内皮素1与尿微量白蛋白水平分析

Analysis of endothelin-1 and urinary microalbumin in patients with obstructive sleep apnea hypopnea syndrome

目的探讨血清内皮素1与尿微量白蛋白在阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者中的水平与病情的相关性。方法选择2013年8月至2015年2月在北京军区总医院住院诊治的OSAHS患者45例作为观察组，选择同期在本院进行体检的健康人45名作为对照组。2组均进行血清内皮素1与尿微量白蛋白水平的检测，比较其差异，并进行相关性分析。结果观察组血清内皮素1与尿微量白蛋白水平均高于对照组，差异有统计学意义[（78±12）ng／L比（30±10）ng／L，（456±57）mg／L比（56±7）mg／L，P〈0．05]。观察组的低通气指数（AHI）明显高于对照组，而夜间睡眠最低血氧饱和度（LSaO：）明显低于对照组，差异均有统计学意义[（31．9±3．3）次／h比（3．3±2．9）次／h，（60．3±3．1）％比（84．7±2．0）％，均P〈0．05]。相关性分析显示内皮素1及尿微量白蛋白水平与AHI值呈正相关（r=0．483、0．445，均P〈0．05），而与LSaO：呈负相关（r=-0．395、-0．436，均P〈0．05）。Logistic多元回归分析结果显示血清内皮素1与尿微量白蛋白水平为导致OSAHS发生的独立危险因素（比值比=3．287、7．873，均P〈0．05）。结论OSAHS患者血清内皮素1与尿微量白蛋白水平增高，是OSAHS发生的独立危险因素。

Objective To analyze the levels of endothelin-1 and urinary microalbumin in patients with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods Totally 45 patients with OSAHS from August 2013 to February 2015 were enrolled （observation group）; at the same period, 45 healthy subjects were selected as control group. The levels of endothelin-I and urinary microalbumin, the hypopnea index （AHI） , the lowest oxygen saturation （ LSaO2 ） were compared between groups; the correlations among them were analyzed. Results The levels of endothelin-1 and urinary microalbumin in observation group were significantly higher than those in control group [ （78 ± 12） ng/L vs （30 ± 10） ng/L, （456 ±57） mg/L vs （56 ±7） mg/L （P 〈0. 05）. The AHI was significantly higher, the LSaO2 was significantly lower in observation group than those in control group [ （31.9 ± 3.3 ） times/h vs （3.3 ± 2. 9） times/h, （60. 3 ± 3.1 ） % vs （ 84. 7 ± 2. 0） % ] （ all P 〈 0. 05 ）. Correlation analysis showed that endothelin-1 and urinary microalbumin were positively correlated with AHI （ r = 0. 483, 0. 445, both P 〈 0. 05）, were negatively correlated with LSaO2 （ r = - 0. 395, - 0. 436, all P 〈 0. 05 ）. Multivariate logistic regression analysis showed that endothelin-1 and urinary microalbumin were the independent risk factors of OSAHS （ odds ratio = 3. 287, 7. 873, both P 〈 0. 05）. Conclusion The levels of endothelin-1 and urinary microalbumin increase in OSAHS patients and are independent risk factors OSAHS.