阻塞性睡眠呼吸暂停低通气综合征患者血栓素B_26-酮-前列腺素F1α和抗心磷脂抗体检测的临床研究

Detection of thromboxane B_2,6-keto-prostaglandin F1α and anticardiolipin antibody in patients with obstructive sleep apnea-hypopnea syndrome

目的 观察阻塞性睡眠呼吸暂停低通气综合征 (OSAHS)患者血栓素B2 (TXB2 )、6 酮 前列腺素F1α(6 K PGF1α)和抗心磷脂抗体 (ACA)的变化及经鼻持续正压通气 (nCPAP)对其影响。方法 选择经多导睡眠图 (PSG)确诊的OSAHS患者 6 0例为试验组 ,根据睡眠呼吸暂停低通气指数 (AHI)、最低血氧饱和度 (SaO2 min)将OSAHS患者分为轻、中重度组 ,并设正常对照组 2 0名 ,19例重度OSAHS患者接受nCPAP治疗为治疗组 ,用酶联免疫吸附试验 (ELISA)检测各组TXB2 、6 K PGF1α和ACA ,比较各试验组与对照组 ,治疗组治疗前、后的各项指标的差异。结果 (1)中重度OSAHS组血浆TXB2 显著高于对照组 (P <0 0 1) ,nCPAP治疗后比治疗前明显下降 (P <0 0 0 1) ;中重度OSAHS组血清抗心磷脂抗体IgG和IgM(ACA IgG、ACA IgM)显著高于对照组 (P <0 0 1) ,nCPAP治疗后比治疗前明显下降 (P<0 0 0 1) ;中重度OSAHS组血浆 6 K PGF1α显著低于对照组 (P <0 0 1) ,nCPAP治疗后比治疗前明显升高 (P <0 0 0 1) ;(2 )TXB2 、ACA与AHI呈正相关 ,与SaO2 呈负相关 (P <0 0 0 1) ;而 6 K PGF1α与AHI呈负相关 ,与SaO2 呈正相关 (P <0 0 0 1)。结论 OSAHS患者易患血栓栓塞性疾病。TXB2 、6 K PGF1α和ACA在OSAHS患者血栓栓塞性疾病高发?

Objective To observe the changes of thromboxane B_2(TXB_2),6-keto-prostaglandin F1α(6-K-PGF1α) and anticardiolipin antibody(ACA)in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS) before and after institution of nasal continuous positive airway pressure(nCPAP). Methods Sixty cases of OSAHS confirmed by polysomnography(PSG) were selected as the trial group,and 20 normal donors without OSAHS were recruited as the control group. Nineteen patients with severe OSAHS were treated by nCPAP. Plasma levels of TXB_2,6-K-PGF1α were detected by enzyme-linked immunosorbent assay(ELISA). Results Plasma(serum) level of TXB_2(ACA) was significantly higher in patients with moderate to severe OSAHS than that in control group( P <0.01),and nCPAP therapy decreased its level significantly( P <0.01). Plasma level of 6-K-PGF1α was significantly lower than that in the control group ( P <0.01), and nCPAP therapy increased its level significantly( P <0.01).TXB_2 and ACA were correlated positively with AHI,and negatively with minimal oxygen saturation( P <0.01). 6-K-PGF1α was correlated negatively with AHI,and positively with minimal oxygen saturation( P <0.01). Conclusions The results indicate that patients with OSAHS are susceptible to thromboembolism disease. TXB_2,6-K-PGF1α,ACA may be associated with the high prevalence of thromboembolism in patients with OSAHS. nCPAP therapy is effective in correcting TXB_2,6-K-PGF1α,ACA.