阻塞性睡眠呼吸暂停低通气综合征相关肺动脉高压患者血清TNF-α、IL-6、CRP及ET-1水平及临床意义

Serum Inflammatory Factors Levels and Clinical Significances in Patients with Pulmonary Hypertension Associated with OSAHS

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)相关肺动脉高压(PH)患者血清炎性因子水平及临床意义。方法选取华北石油中医医院内科2012年1月—2016年12月收治的86例OSAHS(观察组),根据是否合并PH分为A组和B组;同期体检正常者(对照组)作为研究对象,回顾性分析3组的一般临床资料和肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、C反应蛋白(CRP)及内皮素-1(ET-1)水平,并探讨上述指标与OSAHS相关PH的相关性。结果 A、B两组TNF-α、IL-6、CRP及ET-1水平和肺动脉收缩压(PASP)值均高于对照组,且B组上述指标明显高于A组(P<0.05);TNF-α、IL-6、CRP及ET-1与PASP均呈正相关(P<0.05);四者联合诊断OSAHS相关PH具有较高的灵敏度和特异性,优于单独诊断(P<0.05)。结论 OSAHS相关PH血清TNF-α、IL-6、CRP及ET-1水平显著升高,且四者联合诊断OSAHS相关PH具有较高敏感度和特异性,可作为临床上诊断和评估OSAHS相关PH病情进展的理想指标模型。

Objective To investigate levels and clinical significances of serum inflammatory factors in patients with pulmonary hypertension（ PH） associated with obstructive sleep apnea hypopnea syndrom（ OSAHS）. Methods A total of 86 OSAHS patients,which were divided into group A and B according to whether or not having PH,and other 30 healthy people（ control group） taking medical examinations during January 2012 and December 2016 were recruited in this study. General data such as gender,age and disease conditions,and serum levels of tumor necrosis factor alpha（ TNF-α）,interleukin 6（ IL-6） and c-reactive protein（ CRP） and endothelin 1（ ET-1） were retrospectively analyzed in the 3 groups,and correlations between above indexes with OSAHS were analyzed. Results TNF-α,IL-6,CRP and ET-1 levels and pulmonary arterial systolic pressure（ PASP） value in group A and B were significantly higher than those in control group,and the values in group A were significantly higher than those in group B（ P〈0. 05）. TNF-α,IL-6,CRP and ET-1 were positively related to PASP closely（ P〈0. 05）. TNF-α ＋ IL-6 ＋ CRP ＋ ET-1 in combination diagnosis of patients with PH associated with OSAHS had high sensitivity and specificity,and the values by combination diagnosis was superior than those by each diagnosis（ P〈0. 05）. Conclusion Serum TNF-α,IL-6,CRP and ET-1 are significantly increased,and combination diagnosis by them has high sensitivity and specificity,and therefore it may be used as a clinical diagnosis model to assess progress of pathogenetic conditions in patients with PH associated with OSAHS.