阻塞性睡眠呼吸暂停低通气综合征患者呼出气冷凝液和血清SP-D、Leptin水平检测及其临床意义

Detection of SP-D and Leptin in exhaled breath condensate and serum in patients with obstructive sleep apnea-hypopnea syndrome and its clinical significance

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者呼出气冷凝液(EBC)和血清中肺表面活性物质蛋白D(SP-D)、瘦素(Leptin)的水平变化,了解气道炎症发病机制及OSAHS患者SP-D、Leptin的水平与睡眠呼吸暂停低通气指数、体重指数、睡眠最低血氧饱和度的相关性。方法采用多导睡眠检测仪器对OSAHS患者及健康对照组进行睡眠检测,检测时间>7 h。收集受试者的血清及EBC标本,采用ELISA双夹心抗体法检测SP-D、Leptin的水平,分析上述指标与AHI、BMI、LspO_2、最长呼吸暂停时间的相关性。结果 OSAHS组血清中SP-D、Leptin水平均高于对健康对照组(P<0.05);OSAHS组、健康对照组EBC中SP-D、Leptin因子EBC中的水平含量极低,无法检测出。OSAHS组血清中SP-D、Leptin水平与AHI、BMI呈正相关;与LspO_2、最长呼吸暂停时间呈负相关,差异有统计学意义(P<0.05)。结论血清及EBC中SP-D、Leptin因子升高,可能参与了OSAHS气道炎症及氧化应激反应,在OSAHS的发病机制中起一定的作用;OSAHS患者血清中SP-D、Leptin水平与AHI、BMI呈正相关,与LspO_2、最长呼吸暂停时间呈负相关,且与疾病的严重程度有关。

Objective To investigate the change level of SP-D and Leptin in the serum and expiratory breath condensate(EBC)of patients with obstructive sleep apnea hypopnea syndrome(OSAHS),to understand the pathogenesis of airway inflammation and the correlation of SP-D and Leptin levels with sleep apnea hypopnea index,body mass index and sleep minimum blood oxygen saturation in OSAHS patients.Methods Using the PSG to detect OSAHS patients and healthy control group,the detection time is more than7hours,collect samples of serum and EBC in all,use ELISA double sandwich antibody assay to detect the level of SP-D and Leptin,analysis the correlation of two indicators and AHI,BMI,LspO2,the longest respiratory pause time.Results The level of SP-D and Leptin in serum in OSAHS are higher than that in the healthy control group(P<0.05);The level of SP-D and Leptin in EBC in the In the OSAHS group and healthy control group are very low and could not be detected;The level of SP-D and Leptin in serum in OSAHS group are positively related with AHI and BMI,are negatively related with LspO2and the longest pause time,the difference is statistically significant(P<0.05).Conclusion The elevated level of SP-D and Leptin in serum and EBC may be involved in airway inflammation and oxidative stress reaction of OSAHS,and it play a role in the pathogenesis of OSAHS;The level of SP-D and Leptin in serum in OSAHS are positively related with AHI and BMI,are negatively related with LspO2and the longest pause time,and are related with the severity of the disease.