经皮下电刺激技术联合他汀类药物治疗对肥胖型阻塞性睡眠呼吸暂停综合征患者脂代谢和氧化应激反应的影响

Effects of subcutaneous electrical stimulation technique combined with statins treatment on lipid metabolism and oxidative stress reactions in patients with obese obstructive sleep apnea syndrome

目的探讨经皮下电刺激技术联合他汀类药物治疗对肥胖型阻塞性睡眠呼吸暂停综合征(OSAS)患者脂代谢和氧化应激反应的影响。方法将76例肥胖型OSAS患者随机分为对照组38例和观察组38例。对照组患者接受阿托伐他汀钙治疗,观察组患者在对照组治疗基础上接受经皮下电刺激技术治疗,两组患者均治疗2个月。采用多导睡眠图(PSG)监测两组患者治疗前后呼吸紊乱指数(RDI)、呼吸努力相关微觉醒(RERA)、呼吸暂停低通气指数(AHI)及睡眠结构变化情况。采用酶联免疫吸附试验检测两组患者治疗前后血清氧化应激指标[8-羟基脱氧鸟苷(8-OHG)、氧化型低密度脂蛋白(ox-LDL)、超氧化物歧化酶(SOD)]及脂代谢指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)]水平并进行比较。结果治疗前两组患者各项指标比较差异均无统计学意义(P>0.05)。两组患者治疗后RDI、AHI、RERA、最长呼吸暂停时间、SpO2<90%所占比例、氧减指数、最大氧减、最长氧减时间、血清8-OHG、ox-LDL、TC、TG及LDL-C水平均低于同组治疗前,血清SOD和HDL-C水平均高于同组治疗前(P<0.05)。治疗后观察组患者RDI、AHI、RERA、最长呼吸暂停时间、SpO2<90%所占比例、氧减指数、最大氧减、最长氧减时间、血清8-OHG、ox-LDL、TC、TG及LDL-C水平均低于对照组,血清SOD和HDL-C水平均高于对照组(P>0.05)。结论经皮下电刺激技术联合他汀类药物治疗不仅可明显改善肥胖型OSAS患者的睡眠结构,纠正脂代谢紊乱,还能有效减轻其氧化应激水平。

Objective To explore the effects of subcutaneous electrical stimulation technique combined with statins treatment on lipid metabolism and oxidative stress reactions in patients with obese obstructive sleep apnea syndrome(OSAS).Methods A total of 76 patients with obese OSAS were randomly divided into control group(38 cases)and observation group(38 cases).Patients in control group received atorvastatin calcium,while patients in observation group received subcutaneous electrical stimulation on basis of the treatment of control group.Patients in two group were treated for 2 months.Polysomnography(PSG)was performed to monitor changes in respiratory disorder index(RDI),respiratory effort related arousal(RERA),apnea and hypopnea index(AHI)and sleep structure of patients in two groups before and after treatment.Enzyme linked immunosorbent assay was performed to detect levels of serum oxidative stress indexes[8-hydroxydeoxyguanosine(8-OHG),oxidized low density lipoprotein(ox-LDL),superoxide dismutase(SOD)]and lipid metabolism indexes[total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)]in patients of two groups before and after treatment.Results There were no significant differences of all indexes between two groups before treatment(P>0.05).RDI,AHI,RERA,maximum apnea time,proportion of SpO2<90%,oxygen depletion index,maximum oxygen depletion,maximum oxygen depletion time,serum 8-OHG,ox-LDL,TC,TG and LDL-C levels after treatment in two groups were lower than those before treatment in the same group,while serum SOD and HDL-C levels were higher than those before treatment in the same group(P<0.05).After treatment,RDI,AHI,RERA,maximum apnea time,proportion of SpO2<90%,oxygen depletion index,maximum oxygen depletion,maximum oxygen depletion time,serum 8-OHG,ox-LDL,TC,TG and LDL-C levels in observation group were lower than those in control group,while the serum SOD and HDL-C levels were higher than those in control group(P>0.05).Conclusion Subcutaneous electrical stimulation technique combined with statins in treatment of obese OSAS can not only significantly improve sleep structure and correct lipid metabolism disorder,but also effectively reduce oxidative stress level.