阻塞性睡眠呼吸暂停低通气综合征患者血清PCSK9及LDL-C水平变化及其对脑梗死的预测作用

Serum PCSK9 and LDL-C level changes in OSAHS and the prediction for OSAHS combined with cerebral infarction

目的 :检测阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清前蛋白转化酶枯草溶菌素-9(PCSK9)及低密度脂蛋白胆固醇(LDL-C)水平变化及其对OSAHS并发脑梗死的预测作用。方法:从本院2010年以来门诊及住院患者中随机抽取OSAHS合并脑梗死患者27例(A组),单纯性OSAHS患者30例(B组)以及健康体检者30例(C组),用ELISA法检测3组患者血清中PCSK9的水平,全自动分析仪检测LDL-C水平。比较3组患者血清PCSK9及LDL-C水平变化,同时比较A、B两组患者睡眠呼吸监测指标,并对其血清PCSK9及LDL-C与睡眠呼吸监测指标进行直线相关分析。结果:1A组患者血清PCSK9、LDL-C水平高于B、C组(P<0.05);2睡眠呼吸监测指标显示,A组患者病情较B组严重(P<0.05);3A、B两组患者血清PCSK9、LDL-C水平分别与其睡眠呼吸暂停低通气指数(AHI)、睡眠呼吸障碍事件占总睡眠时间百分比、血氧饱和度<90%时间占总睡眠时间百分比呈正相关(P<0.05);与最低血氧饱和度及平均最低血氧饱和度呈负相关(P<0.05)。结论:OSAHS患者血清PCSK9及LDL-C升高幅度与其严重程度密切相关,并可作为OSAHS合并脑梗死的预测指标。

Objective：To investigate serum PCSK9 and LDL-C level changes in obstructive sleep apnea-hypopnea syndrome（OSAHS）,and assess the prediction for OSAHS combined with cerebral infarction. Methods：87 patients were admitted to this trial in our hospital,and they were divided into three groups：OSAHS combined with cerebral infarction group（group A）,isolated OSAHS group（group B） and control group（group C）. Serum PCSK9 concentration was measured by ELISA and LDL-C level were measured by automatic biochemical analyzer,and then they were applied SNK test to perform statistical analysis. Polysomnography（PSG） results of group A and group B were also compared. Furthermore,correlational analyses were conducted between the two factors and PSG results in OSAHS associate with cerebral infarction and isolated OSAHS patients respectively. Results： 1Serum PCSK9 and LDL-C levels were higher in group A than those in group B and group C（P〈0.05）. 2PSG results showed that patients in group A were more severe than that in group B（P〈0.05）. 3Serum PCSK9 and LDL-C levels in OSAHS associate with cerebral infarction and isolated OSAHS patients were correlated positively with apnea hypopnea index（AHI）,percentage of sleep time during apnea-hypopnea and percentage of sleep time below 90% oxygen saturation（Sa O2 90%） respectively（P〈0.05）,and those were correlated negatively with the lowest Sa O2 and the average lowest Sa O2respectively（P〈0.05）. Conclusion：The increasing amplitude of serum PCSK9 and LDL-C levels is interrelated with the degree of OSAHS,and can be seem as clinical predictors of OSAHS combined with cerebral infarction.