妊娠合并阻塞性睡眠呼吸暂停患者血压、血糖、炎性细胞因子变化及临床意义

Changes and Clinical Significance of Blood Pressure,Blood Glucose and Inflammatory Factors in Pregnancy with Obstructive Sleep Apnea.

目的探讨妊娠合并阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)患者血压、血糖、炎性细胞因子[白细胞介素-6(interleukin-6,IL-6)、白细胞介素-8(interleukin-8,IL-8)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]的变化及临床意义。方法选取2019年12月~2021年12月江苏大学附属人民医院产科门诊收治的适龄妊娠女性256例,其中59例妊娠合并OSA的女性被纳入妊娠合并OSA组及197例排除OSA的妊娠期女性作为对照组。采集其收缩压、舒张压、心率、空腹末梢血糖及空腹外周血标本,测定外周血中炎性细胞因子(IL-6、IL-8、TNF-α),分析比较妊娠合并OSA患者血压、血糖、炎性细胞因子(IL-6、IL-8、TNF-α)的变化及临床意义。结果妊娠合并OSA组的收缩压、舒张压、空腹末梢血糖、炎性细胞因子(IL-6、IL-8、TNF-α)均较对照组升高(P<0.05),而两组心率比较,差异无统计学意义(P>0.05)。随着OSA严重程度的增加,妊娠合并OSA患者的收缩压、空腹末梢血糖、IL-6也随之上升,且轻度与重度妊娠合并OSA组比较,差异有统计学意义(P<0.05);而伴随夜间最低血氧饱和度(LSaO 2)降低,收缩压、空腹血糖、IL-6出现较明显的上升,轻中度的缺氧与重度缺氧妊娠OSA组之间这些差异则更为显著(P<0.05)。结论妊娠合并OSA患者的血压及血糖、炎性细胞因子(IL-6、IL-8、TNF-α)水平较正常妊娠人群显著升高,且收缩压、空腹末梢血糖、IL-6水平与OSA的严重程度相关。

Objective Objective To investigate the changes of blood pressure,blood glucose,inflammatory factors[interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)]and its clinical significance in pregnancy with obstructive sleep apnea(OSA).Methods A total of 256 pregnant women of appropriate age admitted to Department of Obstetrics,People′s Hospital Affiliated to Jiangsu University from December 2019 to December 2021 were selected.59 pregnant women with OSA were included in the pregnancy with OSA group and 197 pregnant women with OSA excluded were included as the control group.systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate,fasting peripheral blood glucose and fasting peripheral blood samples were collected,inflammatory factors(IL-6,IL-8,TNF-α)in peripheral blood were measured,and the changes of blood pressure,fasting peripheral blood glucose,inflammatory factors(IL-6,IL-8,TNF-α)and their clinical significance were analyzed and compared in pregnancy with OSA patients.Results SBP,DBP,fasting peripheral blood glucose,inflammatory factors(IL-6,IL-8,TNF-α)were higher in pregnancy with OSA patients than those in the control group(P<0.05),and there was no significant difference in heart rate between the two groups(P<0.05).With the increase of OSA severity,the SBP,fasting peripheral blood glucose and IL-6 of pregnancy with OSA patients were also increased,and there were significant differences between mild and severe pregnancy with OSA groups(P<0.05);With the decrease of LSaO 2 at night,there was a significant increase in SBP,fasting peripheral blood glucose and IL-6,and these differences were more significant between mild and moderate hypoxia and severe hypoxia pregnancy with OSA groups(P<0.05).Conclusion The levels of blood pressure,blood glucose and inflammatory factors(IL-6,IL-8,TNF-α)in pregnancy with OSA patients were significantly higher than those in normal pregnancy group,and the SBP,fasting peripheral blood glucose,the levels of IL-6 were correlated with the severity of OSA.