OSAHS患者血清脂多糖结合蛋白和颈动脉粥样硬化的相关性分析

Correlation analysis of serum lipopolysaccharide-binding protein and carotid atherosclerosis in patients with obstructive sleep apnea-hypopnea syndrome

目的评估阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者血清中脂多糖结合蛋白(lipopolysaccharide-binding protein,LBP)和颈动脉内膜中层厚度(carotid intima-media thickness,CIMT)的关系。方法选择2015年5月~2017年12月在北京安贞医院耳鼻咽喉头颈外科就诊的117例疑似OSAHS患者作为研究对象,所有患者均接受多导睡眠监测和B超评估CIMT。结果在无OSAHS患者、轻-中度OSAHS患者、重度OSAHS患者中,平均LBP浓度和CIMT均呈增加趋势,LBP浓度分别为(32.1±10.4)、(32.3±10.8)、(38.1±10.5)μg/ml,重度OSAHS与轻-中度OSAHS患者相比,血清LBP显著增高(P<0.05);平均CIMT分别为(0.52±0.08)、(0.58±0.07)、(0.62±0.13)mm,重度OSAHS与轻-中度OSAHS患者相比,平均CIMT显著增高(P<0.05)。氧减饱和度指数(oxygen desaturation index,ODI)是一个独立于年龄、腰臀比、吸烟、高血压、高密度脂蛋白胆固醇、甘油三酯和空腹葡萄糖(P=0.002,R^2=0.154)等因素预测血清LBP水平的指标。此外,血清LBP可预测CIMT,而且独立于已知动脉粥样硬化危险因素,如肥胖(P<0.001,R^2=0.323)。结论研究结果表明,OSAHS患者LBP和CIMT之间存在相关性,且呈线性相关。

Objective To assess the relationship between serum lipopolysaccharide-binding protein（LBP）and carotid intimal-media thickness（CIMT）in patients with obstructive sleep apnea-hypopnea syndrome（OSAHS）.Methods117 suspected OSAHS patients visited our hospital from May 2015 to Dec 2017 were selected as the study subjects.All patients received polysomnography and CIMT assessment by B-mode ultrasound.Results LBP concentrations and average CIMT increased from patients without OSAHS to those with mild-moderate and severe OSAHS[from（32.1±10.4）to（32.3±10.8）to（38.1±10.5）μg/ml,P=0.017;from（0.52±0.08）to（0.58±0.07）to（0.62±0.13）mm,P=0.006,respectively].Oxygen desaturation index（ODI）was a predictor of serum LBP level independent of age,waist-to hip ratio（WHR）,smoking,hypertension,HDL cholesterol,triglycerides and fasting glucose（P=0.002,R2=0.154）.Furthermore,serum LBP predicted CIMT independently of known risk factors of atherosclerosis including obesity（P〈0.001R2=0.323）.Conclusion There is a correlation between LBP and CIMT in a linear manner in patients with OSAHS.