阻塞性睡眠呼吸暂停低通气综合征患者血浆IL-10、VEGF水平变化及临床意义

Changes of plasma IL-10 and VEGF levels in patients with obstructive sleep apnea hypopnea syndrome and their clinical significance

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆白细胞介素-10(IL-10)、血管内皮生长因子(VEGF)水平变化及临床意义。方法选取2016年3月~2019年3月徐州医科大学附属淮安医院(以下简称"我院")收治的OSAHS患者219例,所有OSAHS患者均行多导睡眠诊断分析系统(PSG)监测,根据每小时睡眠呼吸暂停次数(AHI)将其分为轻度OSAHS组(AHI:5~15次/h,n=69)、中度OSAHS组(AHI:16~30次/h,n=73)、重度OSAHS组(AHI:>30次/h,n=77)。同期随机选取在我院行健康体检的志愿者60名为对照组。比较各组研究对象PSG监测指标;比较各组研究对象血浆IL-10、VEGF水平;采用多元逐步回归分析VEGF、IL-10与一般资料、PSG监测指标的相关性。结果 OSAHS轻、中、重三组的AHI、氧饱和指数(ODI)、血氧饱和度(SaO2)≤90%占比均高于对照组,且呈依次升高趋势(P <0.05);OSAHS轻、中、重三组的最低动脉血氧饱和度(LSaO2)低于对照组,且呈依次下降趋势(P <0.05)。OSAHS轻、中、重三组的VEGF高于对照组,且呈依次升高趋势(P <0.05);OSAHS轻、中、重三组的IL-10低于对照组,且呈依次下降趋势(P <0.05)。多元逐步回归分析结果显示,VEGF与LSaO2呈负相关(r=-0.386,P <0.05),与Epworth嗜睡量表-评分呈正相关(r=0.427,P <0.01);IL-10与LSaO2呈正相关(r=0.461,P <0.01),与年龄、AHI呈负相关(r=-0.402、-0.452,P <0.01或P <0.05)。结论 OSAHS患者中血浆IL-10、VEGF均呈现异常表达,可导致血管异常增生,炎性反应激活,加快OSAHS患者的病情进展。

Objective To investigate the changes and clinical significance of plasma interleukin-10(IL-10)and vascular endothelial growth factor(VEGF)in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods From March 2016 to March 2019,219 patients with OSAHS admitted to Huai′an Hospital Affiliated to Xuzhou Medical University(hereinafter referred to as"our hospital")were selected.All OSAHS patients were monitored by polysomnography diagnostic analysis system(PSG).According to the number of sleep apnea per hour(AHI),they were divided into light OSAHS group(AHI:5-15 times/h,n=69),moderate OSAHS group(AHI:16-30 times/h,n=73),severe OSAHS group(AHI:>30 times/h,n=77).During the same period,60 volunteers who underwent physical examination in our hospital were randomly selected as the control group.PSG monitoring indexes of each group were compared,plasma IL-10 and VEGF levels in each group were compared,the correlation of VEGF and IL-10 with general data and PSG monitoring indicators were analyzed by multiple stepwise regression.Results The proportion of AHI,oxygen saturation index(ODI)and blood oxygen saturation(SaO2)≤90%in the light,medium and heavy OSAHS groups were higher than those in the control group,and increased in turn(P<0.05).The lowest SaO2(LSaO2)of the OSAHS light,medium and heavy groups were lower than those of the control group and showed a downward trend in turn(P<0.05).VEGF in the light,medium and heavy OSAHS groups were higher than those in the control group,and showed an ascending trend(P<0.05),IL-10 in light,medium and heavy OSAHS groups were lower than those in the control group and showed a decreasing trend(P<0.05).The results of multiple stepstep regression analysis showed that VEGF was negatively correlated with LSaO2(r=-0.386,P<0.05),positive correlation with Epworth sleepiness scale-score(r=0.427,P<0.01);IL-10 was positively correlated with LSaO2(r=0.461,P<0.01),it was negatively correlated with age and AHI(r=-0.402,-0.452,P<0.05 or P<0.01).Conclusion Abnormal expression of plasma IL-10 and VEGF in OSAHS patients can lead to vascular dysplasia,inflammatory response activation,and accelerate the disease progression of OSAHS patients.