阻塞性睡眠呼吸暂停低通气综合征患者血清MCP-1、5-HT水平变化及意义

Changes in levels of serum MCP-1 and 5-HT in patients with obstructive sleep apnea hypopnea syndrome

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清单核细胞趋化蛋白-1(MCP-1)、5-羟色胺(5-HT)水平变化及意义。方法 选取107例OSAHS患者(OSAHS组),根据是否发生轻度认知障碍(MCI)分为MCI组(43例)和NMCI组(64例),另选取同期48名体检健康志愿者(对照组)。采用酶联免疫吸附法检测血清MCP-1、5-HT。通过多因素Logistic回归分析影响OSAHS患者MCI发生的因素,受试者工作特征(ROC)曲线分析血清MCP-1、5-HT水平对OSAHS患者MCI发生的预测价值。结果 与对照组比较,OSAHS组血清MCP-1水平升高,5-HT水平降低(P均<0.05)。107例OSAHS患者MCI发生率为40.19%(43/107)。与NMCI组比较,MCI组血清MCP-1水平升高,5-HT水平降低(P均<0.05)。年龄增加、病情程度重度和MCP-1升高为OSAHS患者MCI发生的独立危险因素,5-HT升高为独立保护因素(P均<0.05)。血清MCP-1、5-HT联合预测OSAHS患者MCI的曲线下面积为0.906,大于血清MCP-1、5-HT单独预测的0.805、0.828(P均<0.05)。结论 OSAHS患者血清MCP-1水平升高,5-HT水平降低,与MCI发生密切相关,血清MCP-1联合5-HT检测对预测OSAHS患者MCI发生有较高价值。

Objective To investigate the changes in levels of serum monocyte chemotactic protein-1(MCP-1) and 5-hydroxytryptamine(5-HT) in patients with obstructive sleep apnea hypopnea syndrome(OSAHS) and their clinical significance.Methods Totally 107 OSAHS patients(OSAHS group) were selected and divided into the MCI group(43cases) and NMCI group(64 cases) according to whether mild cognitive impairment(MCI) occurred or not,and 48 healthy volunteers with medical checkups in the same period(control group) were selected.Serum MCP-1 and 5-HT levels were measured by ELISA.Factors affecting the occurrence of MCI in OSAHS patients were analyzed by multifactorial Logistic regression,and the predictive value of serum MCP-1 and 5-HT levels for MCI in OSAHS patients was analyzed by receiver operating characteristic(ROC) curve.Results Compared with the control group,the serum MCP-1 level increased and 5-HT level decreased in the OSAHS group(both P<0.05).The incidence of MCI in 107 OSAHS patients was 40.19%(43/107).Compared with the NMCI group,the serum MCP-1 level increased and 5-HT level decreased in the MCI group(both P<0.05).Increasing age,severity of disease and elevated MCP-1 were independent risk factors for the development of MCI in patients with OSAHS,and elevated 5-HT was an independent protective factor(all P<0.05).The area under the curve of serum MCP-1 and 5-HT in predicting MCI in patients with OSAHS was 0.906,which was greater than that(0.805,0.828) of serum MCP-1 and 5-HT alone(both P<0.05).Conclusion The elevated serum MCP-1 level and reduced 5-HT level in OSAHS patients are closely associated with MCI,and the combination detection of serum MCP-1 and 5-HT has a high predictive value for the occurrence of MCI in OSAHS patients.