慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停低通气综合征与脂联素、8-异前列腺素F2α的关系

Clinical significance of adiponectin and 8-iso prostaglandin F2α in patients with chronic obstructive pulmonary disease complicated with obstructive sleep apnea hypopnea syndrome

目的探讨慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)(简称重叠综合征,OS)与血清脂联素、8-异前列腺素F2α的关系。方法选取海南省人民医院COPD患者80例(COPD组),OS患者40例(OS组)共120例患者,收集患者年龄、性别、吸烟、体重指数(BMI)、第一秒钟用力呼气量与用力肺活量比值(FEV1%)等基本情况。酶联免疫吸附试验(ELISA)检测两组患者血清脂联素、8-异前列腺素F2α水平;多重线性回归分别分析OS与脂联素、8-异前列腺素F2α的关系。结果两组患者年龄、性别、吸烟、血压、血糖、血脂差异无统计学意义(P>0.05);OS组患者BMI和8-异前列腺素F2α高于COPD组(P<0.05);OS组患者FEV1%和脂联素低于COPD组(P<0.05)。多重线性回归调整年龄、性别、BMI、FEV1%等混杂因素后,OS与脂联素有负向影响,与8-异前列腺素F2α有正向影响(P<0.05)。结论OS较单纯COPD抗炎作用减退,抗胰岛素抵抗和抗动脉粥样硬化作用减退,氧化应激作用增强,提示COPD合并OSAHS增加COPD患者多种代谢紊乱和心脑血管疾病的风险。

Objective To investigate clinical significance of serum adiponectin and 8-iso prostaglandin F2αin patients with chronic obstructive pulmonary disease(COPD)complicated with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 120 patients were enrolled in this study.The patients were divided into COPD group(n=80 cases)and OS group(COPD combined with OSAHS,n=40 cases).The age,gender,smoking,body mass index(BMI),forced vital capacity rate of one second(FEV1%/FVC)were recorded.Serum levels of adiponectin and 8-iso prostaglandin F2αwere measured by ELISA.Results There were no significant differences in age,gender,smoking,blood pressure,blood glucose and blood lipid between the two groups(P>0.05).Compared with patients with COPD,OS patients experienced increase in BMI and 8-iso prostaglandin F2αwhile decrease in FEV1%/FVC and adiponectin(P<0.05).After adjustment for age,gender,BMI,FEV1%/FVC and other confounding factors,OS has a negative relationship with adiponectin(β=-2.018)and positive relationship with 8-iso prostaglandin F2α(β=3.824)(P<0.05).Conclusions OS may increase the risk of metabolic disorders,cardiovascular diseases,and cerebrovascular diseases.