NF-κ B下游炎症因子在非肥胖OSAS患者外周血中的表达及临床意义

Expression of NF-κ B downstream inflammatory factors in non-obese patients with obstruction sleep apnea syndrome

目的分析NF-κ B下游炎症因子在非肥胖阻塞性睡眠呼吸暂停综合征(OSAS)患者外周血中的表达及其与OSAS患者疾病严重程度的相关性,以评价其临床价值。方法选择夜间打鼾憋气伴日间嗜睡的非肥胖人群,进行多导睡眠监测(PSG),根据AHI指数分为非OSAS组98例,OSAS组100例(轻度45例、中度30例、重度25例),所有入组对象抽取外周静脉血,采用ELISA法检测外周血IL-6、TNF-α、C反应蛋白(CRP),分析两组间上述指标的差异,并与呼吸暂停低通气指数(AHI)进行相关性分析。结果与非OSAS组相比,OSAS组外周血IL-6、TNF-α、CRP升高(均P<0.05);轻度OSAS患者AHI与TNF-α、CRP不相关(r=0.170、0.239,均P>0.05),与IL-6呈低度相关(r=0.330,P<0.05),中度患者AHI与IL-6、TNF-α、CRP呈中度相关(r=0.637、0.644、0.705,均P<0.05),重度患者AHI与IL-6、TNF-α、CRP呈高度相关(r=0.821、0.805、0.854,均P<0.05)。结论非肥胖人群OSAS患者外周血炎症指标的表达较非OSAS者升高,并在中、重度患者中与AHI相关,这些指标对OSAS的诊断及严重程度的评价有一定的临床价值。

Objective To investigate the expression of NF-κ B downstream inflammatory factors in non-obese patients with obstructive sleep apnea syndrome（OSAS） and its relation to the disease severity.Methods One hundred and ninety eight non-obese subjects with nocturnal snoring with daytime somnolence were monitored with polysomnography（PSG）,according to apnea hypopnea index（AHI）,100 subjects were classified as OSAS and 98 as non-OSAS.Serum IL-6,TNF-α and CRP levels were measured with ELISA method.Results Compared with the non-OSAS group,serum IL-6,TNF-α and CRP were elevated significantly（P〈0.05）.In OSAS AHI score and TNF alpha,mild group were not associated with CRP（r=0.170、0.239,P〈0.05）associated with IL-6 mild（r= 0.330,P〈0.05） and OSAS moderate group AHI index and IL-6,TNF alpha,moderately correlated to the CRP（r=0.637、0.644、0.705,P〈0.05）,severe group and IL-6,TNF alpha,CRP was highly correlated（r= 0.821、0.805、0.854,P〈0.05）.Conclusion Non-obese people the expression of peripheral blood in patients with OSAS group inflammation index than in OSAS group increases,and in the middle and severe population associated with AHI index,evaluation of diagnosis and severity of OSAS has certain clinical value.