OSAHS患者ADMA、25-羟维生素D和BMI变化及其与疾病严重程度相关性研究

Correlation of ADMA,25-hydroxyvitamin D and BMI with severity of OSAHS

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者二甲基精氨酸(ADMA)、25-羟维生素D(25-OHD)及体质量指数(BMI)变化与其疾病严重程度相关性。方法取2018年5月至2019年7月本院OSAHS患者60例作为观察组,根据呼吸暂停低通气指数(AHI)将OSAHS患者分为轻度(5次/h≤AHI<20次/h)20例、中度(20次/h≤AHI<40次/h)20例、重度(≥40次/h)20例,另选取本院同期体检健康人员35例作为对照组。检测各组受试者血清ADMA、25-羟维生素D水平,体质量指数(BMI),睡眠结构(睡眠潜伏期、总睡眠时间、觉醒总时间、觉醒次数),动脉血气指标[血氧分压(PaO2)、二氧化碳分压(PaCO2)、血氧饱和度(SaO2)、PH值],呼吸指标"呼吸暂停次数、低通气次数、呼吸暂停低通气指数(AHI)"并收集一般信息和临床资料进行相关性分析。结果轻中重患者血清二甲基精氨酸(ADMA)、BMI明显高于对照组,25-羟维生素D明显低于对照组,差异有统计学意义(P<0.05);血气分析:OSAHS组PaCO2水平高于正常对照组,而PaO2、SaO2、PH水平低于正常对照组,差异有统计学意义(P<0.05);睡眠结构:睡眠潜伏期、觉醒总时间、觉醒次数大于正常对照组,总睡眠时间小于正常对照组,差异有统计学意义(P<0.05);呼吸指标OSAHS组呼吸暂停次数、低通气次数、AHI明显高于对照组,差异有统计学意义(P<0.05)。Pearson检验相关性分析发现血清ADMA、BMI与OSAHS患者疾病严重程度正相关,而25-羟维生素D相反,(P<0.05)。结论ADMA、BMI的增加和25-羟维生素D的减少可直接导致OSAHS的产生和发展,控制改善ADMA、25-羟维生素D和BMI对OSAHS的防治具有重要意义。

Objective To investigate the correlation between the changes of ADMA,25-hydroxyvitamin D,body mass index and the severity of obstructive sleep apnea hypopnea syndrome(OSAHS).Methods 50 cases of OSAHS patients in Our Hospital from May 2018 to July 2019 were selected as the observation group.According to the apnea hypopnea index(AHI),the patients were divided into mild(5 times/h≤AHI<20 times/h),moderate(20 times/h≤AHI<40 times/h),and severe(≥40 times/h)17 cases.The levels of serum ADMA,25-hydroxyvitamin D,body mass index(BMI),sleep structure:sleep latency,total sleep time,total wake-up time,wake-up times,arterial blood gas indicators:PaO2,PaCO2,SaO2,pH value,respiratory indexes:apnea times,hypoventilation times,temporary breathing Apnea hypopnea index(AHI)was used to collect general information and clinical data for correlation analysis.Results The serum levels of ADMA and BMI of mild,moderate and severe patients were significantly higher than those of the control group,and 25-hydroxyvitamin D was significantly lower than that of the control group,The difference was statistically significant(P<0.05);blood gas analysis:the level of PaCO2 in OSAHS group was higher than that in normal control group,while PaO2,SaO2 and pH levels were lower than those in normal control group,the difference was statistically significant(P<0.05);sleep structure:sleep latency,total time of awakening and times of awakening were greater than those of normal control group,and total sleep time was shorter than that of normal control group,the difference was statistically significant(P<0.05)The number of apnea,times of hypoventilation and AHI in OSAHS group were significantly higher than those in control group(P<0.05).Pearson test showed that serum ADMA and BMI were positively correlated with the severity of OSAHS,while 25-hydroxyvitamin D was the opposite.Conclusion The increase of ADMA,BMI and the decrease of 25-hydroxyvitamin D can directly lead to the generation and development of OSAHS.It is important to control and improve ADMA,25-hydroxyvitamin D and BMI for the prevention and treatment of OSAHS.