阻塞性睡眠呼吸暂停综合征患者抗心磷脂抗体水平分析及其临床意义

Clinical significance of aicardiolipin antibody in patients with obstructive sleep apneahypopnea syndrome

目的:探讨阻塞性睡眠呼吸暂停综合征(OSAHS)患者抗心磷脂抗体(ACA)水平及其临床意义。方法:选取OSAHS患者(OSAHS组)179例和体检健康者(NC组)100名,采用酶联吸附免疫法(ELISA)检测两组血清ACA-IgG、ACA-IgM及ACA-IgA水平。另将OSAHS组分为ACA阳性亚组108例和ACA非阳性亚组71例,比较两组的临床资料和多导睡眠监测记录仪(PSG)监测指标。结果:(1)OSAHS组BMI、SBP、DBP、TG、TC、AHI及吸烟率均高于NC组,HDL-C和SaO_2低于NC组(P<0.05或P<0.01);(2)OSAHS组ACA-IgG、ACA-IgM及IgG+IgM的阳性率高于NC组,且OSAHS组ACA-IgG和ACA-IgM的表达水平高于NC组(P均<0.01);(3)与非阳性亚组比较,阳性亚组AHI升高[(38.42±7.32)vs(49.53±7.84)次/h],SaO_2降低[(71.39±9.22)%vs(63.51±9.10)%](P<0.01),而其他指标比较,差异均无统计学意义(P>0.05)。结论:OSAHS患者ACA水平升高,其水平高低可能与夜间低氧血症的严重程度有关。

Objective： To explore clinical significance of aicardiolipin antibody （ACA） in patients with obstructive sleep apneahypopnea syndrome （OSAHS）.Methods： A total of 179 cases with OSAHS （OSAHS group） and 100 healthy people （NC group） were selected in this study,and the serum levels of ACA-IgG,ACAIgM and ACA-IgA were tested by ELISA.Then the OSAHS group was classified into ACA positive and negative subgroups,the clinical data and PSG index were compared between the two subgroups.Results： （1） The BMI,SBP,DBP,TG,TC,AHI and smoking rate were higher,HDL-C and SaO_2 were lower in OSAHS group than in NC group （P〈0.05 or P〈0.01）; （2） The positive rate of ACA-IgG,ACA-IgM and IgG ＋ IgM,and expression levels of ACA-IgG and ACA-IgM were higher in OSAHS group than those in NC group （All P〈0.01）; （3） Compared with ACA negative subgroup,AHI was raised [ （58.42 ± 10.32） vs （69.53 ± 10.84） times/h]and SaO_2 was reduced[ （71.39 ± 9.22） % vs （63.51 ± 9.10） %] in ACA positive subgroup （P〈0.01）,but there were no statistical significances on other index between the two subgroups （P〈0.05）.Conclusion： The level of ACA elevates in patients with OSAHS,and its level may be associated with the severity of the nocturnal hypoxemia.