成人OSAHS患者血清胰岛素样生长因子-1的表达及其意义

Expression and significance of serum insulin-like growth factor-1 in patients with obstructive sleep apnea hypopnea syndrome

目的:探讨成人OSAHS患者血清胰岛素样生长因子-1(IGF-1)的表达及意义。方法:通过PSG确诊的OSAHS患者107例为观察组,按照AHI分为重、中、轻3组;以无OSAHS的健康人50例为对照组;ELISA法测定入组者血清IGF-1;30例获得随访的重度患者进行手术及CPAP治疗3个月及半年后复测IGF-1、PSG。结果:(1)随着OSAHS病情加重,患者血清IGF-1水平均逐渐下降(F=37.732,P<0.01),其中轻度组与对照组无明显差别(P>0.05);其他组相互比较均有明显差别(P<0.01)。(2)OSAHS患者血清IGF-1水平和BMI、年龄无关联(P>0.05),与LSaO_2呈负相关,与AHI呈正相关(P<0.01)。(3)30例重度患者经CPAP+手术方案治疗3个月后血清IGF-1水平[(46.56±3.74)μg/L]较治疗前[(42.79±4.87)μg/L]稍有上升(P<0.01)。治疗半年后血清IGF-1水平[(56.61±5.46)μg/L]明显上升(P<0.01);AHI水平(18.72±7.36)较治疗前(48.77±10.51)明显下降,LSaO_2[(87.42±8.61)%]较前[(68.33±10.24)%]上升(P<0.01)。结论:OSAHS患者血清IGF-1水平下降,可能与并发胰岛素抵抗有关;手术联合半年以上的CPAP治疗可明显降低AHI,并改善LSaO_2及血清IGF-1的水平;可采取血清IGF-1水平监测对疗效进行评估。

Objective：To investigate the expression and significance of serum insulin-like growth factor-1（IGF-1）in adult patients with obstructive sleep apnea hypopnea syndrome（OSAHS）.Method：One hundred and seven patients of OSAHS diagnosed with PSG were included in the observation group,which were divided into heavy,medium and light group according to AHI.Fifty case of healthy people without OSAHS were included in control group.Serum IGF-1 were measured by ELISA.Thirty patients of heavy OSAHS received surgery and CPAP treatment for three months,and were retested the levels of IGF-1 and PSG six months later.Result：（1）With the increase of OSAHS severity,the levels of serum IGF-1 were gradually decreased（F=37.732,P〈0.01）.There was no significant difference between mild group and healthy people（P〈0.05）,while there was significant differences between the remaining groups（P〈0.01）.（2）Serum IGF-1 level has no correlation with BMI and age in OSAHS patients（P〈0.05）,and negatively correlated with LSaO2,and positively correlated with AHI（P〈0.01）.（3）Serum IGF-1 level[（46.56±3.74）μg/L]increased slightly compared with those before treatment[（42.79±4.87）μg/L]in 30 severe patients after treatment with 3 months CPAP and regimen（P〈0.01）.Serum IGF-1 level[（56.61±5.46）μg/L]increased significantly after treatment for six months;AHI level（18.72±7.36）was significantly lower than that before treatment（48.77±10.51）,and LSaO2[（87.42±8.61）%]increased significantly than that before treatment[（68.33±10.24）%].Conclusion：OSAHS patients with decreased serum IGF-1 level may be associated with concurrent insulin resistance.Surgery combined with more than half a year of CPAP treatment can significantly reduce AHI,improve the level of LSaO_2 and serum IGF-1.Serum IGF-1 levels could be used as a monitor of efficacy evaluation.