文章摘要
陶一江,陈建荣,夏秋萍,朱〓杰,姚〓坚.阻塞性睡眠呼吸暂停低通气综合征患者呼出气冷凝液中8-异前列腺素的检测及其临床意义[J].南京医科大学学报,2009,29(10):1427~1431
阻塞性睡眠呼吸暂停低通气综合征患者呼出气冷凝液中8-异前列腺素的检测及其临床意义
Changes and significances of 8-isoprostane in exhaled breath condensate in obstructive sleep apnea hypopnea syndrome
投稿时间:2009-04-01  
DOI:10.7655
中文关键词: 阻塞性睡眠呼吸暂停低通气综合征  经鼻持续气道正压通气  8-异前列腺素
英文关键词: obstructive sleep apnea hypopnea syndrome  continuous positive airway pressure  8-isoprostane
基金项目:南通市社会发展科技项目(S2006050)
作者单位
陶一江 南通市第一人民医院呼吸科,江苏 南通〓226001 
陈建荣  
夏秋萍  
朱〓杰  
姚〓坚  
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中文摘要:
      目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者8-异前列腺素(8-isoPG)的变化及其临床意义?方法:收集40例OSAHS患者和30例健康对照者睡前和晨起的呼出气冷凝液(EBC)以及晨起的血清,应用ELISA法测定EBC和血清中的8-isoPG浓度,其中20例OSAHS患者经治疗3个月后,复查EBC和血清中的8-isoPG浓度?结果:① OSHAS组EBC中8-isoPG测定值睡前为(13.08 ± 1.42)pg/ml,晨起为(14.93 ± 1.39)pg/ml,差异有统计学意义(P < 0.01);对照组睡前为(11.06 + 0.72)pg/ml,晨起为(10.97 ± 0.70)pg/ml,差异无统计学意义(P > 0.05);2组晨起与睡前8-isoPG比较差异有统计学意义(P < 0.01);②血清中8-isoPG测定值OSHAS组晨起为(36.59 ± 14.89)pg/ml,对照组晨起为(19.91 ± 7.76)pg/ml,两组比较差异有统计学意义(P < 0.01);③OSAHS组患者晨起EBC与血清中8-isoPG水平成正相关(r=0.69,P < 0.01);④20例OSAHS患者经治疗(其中11例使用经鼻持续气道正压通气治疗,9例进行腭垂软腭咽成形术)3个月后,EBC中8-isoPG睡前为(12.13±1.39)pg/ml,晨起为(12.02 ± 1.36)pg/ml,晨起血清为(23.00 ± 9.54)pg/ml,分别与治疗前比较差异有统计学意义(P < 0.01);⑤OSAHS患者晨起EBC中8-isoPG浓度与睡眠呼吸暂停低通气指数(AHI)?颈围和腰围正相关(r值分别为0.65?0.43?0.34,P均< 0.05),与晨起血氧分压(PaO2)负相关(r=-0.31,P < 0.05)?结论:EBC中8-isoPG是反映OSAHS患者氧化应激反应的较好指标,对研究OSAHS发生机制?判断严重程度和评估治疗效果具有重要的临床意义?
英文摘要:
      Objective:To investigate the change of the airway oxidative stress marker,8-isoprostane(8-isoPG),and its clinical significance for patients with obstructive sleep apnea hypopnea syndrome(OSAHS). Methods:40 OSAHS patients and 30 normal controls were recruited in the study. Exhaled breath condensate(EBC) and serum 8-isoPG were assayed by ELLSA. 20 OSAHS patients were assayed again after three months’ treatment. Results:①The concentrations of 8-isoPG in EBC were (13.08 ± 1.42)pg/ml before sleep vs (14.93±1.39)pg/ml after sleep in 40 OSAHS patients(P < 0.01),and (11.06±0.72)pg/ml before sleep vs (10.97±0.7)pg/ml after sleep in 30 normal controls (P > 0.05). The concentrations of 8-isoPG in EBC after sleep were significantly higher than those before sleep in 40 OSAHS patients (P < 0.01). ②The serum levels of 8-isoPG were significantly higher in 40 OSAHS patients (36.59 ±14.89) pg/ml than those in 30 normal controls (19.91±7.76) pg/ml (P < 0.01). ③The concentrations of 8-isoPG in EBC of OSAHS patients after sleep were positive correlated with serum 8-isoPG levels (r=0.685,P < 0.01). ④After three months’ treatment with either auto continuous positive airway pressure (Auto-CPAP)or uvulopalatopharyngoplasty(UPPP),there was a significant decrease in the concentrations of 8-isoPG in both EBC and serum of 20 OSAHS patients before sleep and after sleep(all P < 0.01). ⑤ The concentrations of 8-isoPG in EBC of OSAHS patients after sleep were positive correlated with AHI,neck and waist circumferences(r=0.65,0.43 and 0.34,all P < 0.05)and negative with PaO2 (r=-0.31,P < 0.05). Conclusion:These findings suggest that oxidative stress is characteristic of OSAHS patients. The levels of 8-isoPG in exhaled breath condensate depend on the severity of the OSAHS and may prove useful in monitoring of airway oxidative stress of OSAHS.
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