OSAHS合并认知障碍患者肺泡巨噬细胞表达TREM2的研究

Expression of TREM2 in alveolar macrophages of patients with obstructive sleep apnea hypopnea syndrome complicated with cognitive impairment

目的研究髓系细胞触发受体2(TREM2)在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并不同程度认知功能障碍患者肺泡巨噬细胞(AM)上的表达水平,并探讨其临床意义。方法依据简明智能精神状态检查量表(MMSE)将79例OSAHS患者分成无认知障碍组21例(A组),轻度认知障碍组23例(B组),中度认知障碍组20例(C组),重度认知障碍组15例(D组),采用支气管肺泡灌洗方法对以上各组患者提取、纯化AM。分别采用实时荧光定量(RT-PCR)法和流式细胞仪(FCM)检测TREM2 mRNA和蛋白在AM上的表达水平,磁共振弥散张量成像(DTI)测定各组患者额叶白质FA值。结果 TREM2 mRNA及蛋白表达量A组<B组<C组<D组,4组间两两比较差异均具有统计学意义(P<0.05),各组额叶白质FA值分别为(0.713±0.062)、(0.698±0.053)、(0.437±0.051)、(0.238±0.032),除A、B组差异无统计学意义外,其余各组间两两比较差异均具有统计学意义(P<0.05)。相关分析显示,TREM2 mRNA及蛋白表达均与额叶白质FA值呈负相关(r分别为-0.583、-0.472,P<0.05)。结论 TREM2在OSAHS合并认知障碍患者AM中表达增加,其可能在OSAHS患者发生认知障碍的过程中起重要调节作用。

Objective To investigate the expression level of trem2 in alveolar macrophages （AM） in patients with obstructive sleep apnea hypopnea syndrome （OSAHS） with different degrees of cognitive impairment and explore its clinical significance. Methods According to the brief mental state examination （MMSE）, 79 patients with OSAHS were divided into 21 groups with no cognitive impairment （group A） , Mild cognitive impairment group 23 cases （group B）, moderate cognitive impairment group 20 cases （group C ）, severe cognitive impairment group 15 cases （group D ）, Bronehoalveolar lavage was used to extract and purify AM from the above groups. Real time fluorescence quantitative （RT-PCR） and flow eytometry （FCM） were used to detect the expression levels of TREM2 mRNA and protein on AM, and magnetic resonance diffusion tensor imaging （DTI） was used to measure FA values of frontal lobe white matter in each group. Results ： The expressions of TREM2 mRNA and protein in group A were less than group B, group C, group D, and it was statistically significant among four group models （P 〈 0.05）. The white matter FA values of frontal lobe in each group were （0.713±0.062） , （0.698 ±0.053） , （0.437 ±0.051 ）, （0.238 ±0.032）. Besides A and B group, the difference was not statistically significant, and the other groups were statistically significant （P 〈 0.05）. Correlation analysis showed that TREM2 mRNA and protein expression were negatively correlated with frontal white matter FA value （R are -0.583 and -0.472 respec- tivel, P 〈 0.05）. conclusions TREM2 increases the expression of AM in OSAHS patients with cognitive impairment and may play an important regulatory role in the development of cognitive impairment in OSAHS patients.