摘要
目的通过检测阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者应用持续气道正压通气(CPAP治疗前后血清白细胞介素-23(IL-23)及C反应蛋白(CRP)浓度的变化,探讨OSAHS患者的发病机制及治疗。方法选择经多导睡眠图确诊为中重度OSAHS的58例患者为试验组,选择匹配试验组患者年龄、性别及体重指数的门诊健康体检者57例为对照组。检测对照组血清IL-23及CRP浓度水平,检测试验组应用呼吸机前及应用CPAP 3个月后血清IL-23及CRP浓度。结果 OSAHS患者CPAP治疗前血清IL-23及CRP浓度水平高于对照组,差异有统计学意义(均P<0.05)。OSAHS患者应用CPAP治疗3个月后的血清IL-23及CRP浓度水平显著低于应用CPAP前(均P<0.05)。OSAHS患者血清IL-23及CRP浓度与呼吸暂停低通气指数呈正相关(r值分别为0.756、0.345,均P<0.05),与平均氧饱和度呈负相关(r值分别为–0.715、–0.334,均P<0.05)。结论血清IL-23及CRP水平与OSAHS的严重程度呈正相关,经CPAP治疗后IL-23及CRP水平下降,提示CPAP可能通过降低OSAHS患者的炎症反应进而纠正缺氧,从而发挥治疗作用。
Objective To investigate the pathogenesis and treatment of obstructive sleep apnea hypopnea syndrome(OSAHS) by detecting the changes of serum interleukin-23(IL-23) and C-reactive protein(CRP) levels of the OSAHS patients before and after treatment with continuous positive airway pressure(CPAP). Methods Fifty-eight patients with moderate to severe OSAHS diagnosed by polysomnography were recruited as an experimental group,57 out-patient healthy subjects with matched age, sex and body mass index of the experimental group were enrolled as a control group. The serum concentrations of IL-23 and CRP in the experimental group were detected and compared before and after CPAP application for 3 months. The serum concentrations of IL-23 and CRP in the control group were also measured. Results The serum levels of IL-23 and CRP in the OSAHS patients were significantly higher than those in the normal control subjects(P<0.05). The serum levels of IL-23 and CRP in the OSAHS patients after CPAP treatment were significantly lower than those before CPAP treatment(P<0.05). The serum concentrations of IL-23 and CRP were positively correlated with apnea hypopnea index(r=0.756, r=0.345, P<0.05, respectively), and negatively correlated with mean oxygen saturation(r=–0.715, r=–0.334, P<0.05, respectively). Conclusions The serum levels of IL-23 and CRP are positively correlated with the severity of OSAHS. After CPAP treatment, the levels of IL-23 and CRP decrease, which indicates that CPAP treatment may reduce the inflammatory reaction and correct anoxia of OSAHS patients.
作者
周晓蕾
张娟
赵志国
邝红萍
汤兵祥
张曼林
ZHOU Xiaolei;ZHANG Juan;ZHAO Zhiguo;KUANG Hongping;TANG Bingxiang;ZHANG Manlin(Department of Respiratory and Critical Care Medicine,Henan Chest Hospital,Zhengzhou,Henan 450000,P.R.China)
出处
《中国呼吸与危重监护杂志》
CAS
CSCD
北大核心
2020年第1期36-40,共5页
Chinese Journal of Respiratory and Critical Care Medicine
基金
河南省科技攻关项目(152102310426)