OSA患者肾素(原)受体水平与性别及疾病严重程度的相关性

Correlation between(Pro)renin receptor levels and gender and disease severity in patients with obstructive sleep apnea syndrome

目的:探讨OSA患者肾素(原)受体[(P)RR]水平与患者性别和疾病严重程度的相关性。方法:2010-03-2018-03期间选择接受治疗并确诊的80例OSA患者(OSA组)为研究对象,另外选择20例健康体检者作为对照组,考察健康人、不同性别和疾病严重程度OSA患者的血浆可溶性肾素(原)受体[s(P)RR]水平及临床参数的变化。结果:OSA组的血浆s(P)RR浓度显著高于对照组。在所有患者中,血浆s(P)RR浓度均随着疾病程度的升高而升高,在男性和女性之间均表现出相同的变化趋势。此外,血浆s(P)RR浓度与所有患者的腰臀比、血红蛋白A1c(HbA1c)、AHI和氧减饱和度指数呈显著正相关,而与肾小球滤过率(eGFR)、平均血氧饱和度(MSpO2)2和最低血氧饱和度(minSpO2)呈显著负相关(P<0.05)。女性受试者中,血浆s(P)RR浓度与腰臀比和AHI呈显著正相关,而与eGFR呈显著负相关(P<0.05)。男性受试者中,血浆s(P)RR浓度与腰臀比、HbA1c、肾素水平、AHI和氧减饱和度指数呈显著正相关,而与eGFR、MSpO2和minSpO2呈显著负相关(P<0.05)。应用经鼻持续气道正压通气呼吸机治疗后患者的血浆s(P)RR浓度均显著降低。另外,Epworth嗜睡量表评分、AHI、MSpO2、minSpO2和氧减饱和度指数均得到显著改善(P<0.05)。结论:OSA患者的血浆s(P)RR水平与患者的疾病严重程度呈显著正相关,可直接反映患者的疾病严重程度。此外,患者的腰臀比和HbA1c过高、eGFR过低均可影响血浆s(P)RR水平,并有可能导致OSA病情加重。

Objective:The aim of this study is to investigate the relationship between the level of(pro)renin(P)RR in obstructive sleep apnea syndrome(OSA)patients,and the gender and disease severity of the disease.Method:From March 2010 to March 2018,eighty OSA patients who were treated and diagnosed in our hospital were selected as subjects.Another 20 healthy subjects were selected as the control group.Plasma soluble(pro)renin receptor[s(P)RR]levels and clinical parameters were measured in healthy subjects and OSA patients with different sex and disease severity.Result:The plasma s(P)RR concentrations were significantly higher in OSA patients than that in control group.In all patients,plasma s(P)RR concentrations increased with increasing disease levels and showed the same trend between men and women.In addition,in all patients,plasma s(P)RR concentrations were significantly positively correlated with waist-to-hip ratio,HbA1 c,AHI,and oxygen desaturation index.There was a significant negative correlation between saturation(MSpO2)and minimum oxygen saturation(minSpO2)(P<0.05).In female subjects,plasma s(P)RR concentrations were significantly positively correlated with waist-to-hip ratio and AHI,but significantly negatively correlated with eGFR(P<0.05).In male subjects,plasma s(P)RR concentration was significantly positively correlated with waist-to-hip ratio,HbA1 c,renin level,AHI and oxygen desaturation index,but negatively correlated with eGFR,MSpO2 and minSpO2(P<0.05).Plasma s(P)RR concentrations were significantly reduced after treatment with nasal continuous positive airway pressure ventilator.In addition,ESS,AHI,MSpO2,minSpO2,and oxygen desaturation index were all significantly improved(P<0.05).Conclusion:Plasma s(P)RR levels in OSA patients are significantly positively correlated with the severity of the disease and can directly reflect the severity of the disease.In addition,the patient with higher waist-to-hip ratio and HbA1c,and lower eGFR can effect plasma s(P)RR levels,and may lead to OSA aggravation.