【作者】 张伯之；

【导师】 刘吉祥；

【作者基本信息】 天津医科大学 ， 耳鼻咽喉科学， 2008， 硕士

【摘要】 目的研究阻塞型睡眠呼吸暂停低通气综合征（obstructive sleep apneahyponea syndrome,OSAHS）患者血清白细胞介素6（IL-6）的变化,并观察短期经鼻持续气道正压通气（nasal continuous positive airway pressure,nCPAP）治疗对OSAHS患者血清IL-6的水平影响,并探讨nCPAP治疗对患者心血管系统的保护作用。方法选择中、重度OSAHS患者26例（年龄:49±8岁,BMI:29.37±1.82kg/m²）和正常对照组24例（年龄:48±10岁,BMI:28.51±1.99kg/m²）,测定并比较两组AHI及夜间最低SaO₂,平均最低SaO₂以及两组血清IL-6的水平,同时对OSAHS患者进行nCPAP治疗7天,测定治疗后的AHI及夜间最低SaO₂,平均最低SaO₂,血清IL-6水平,与治疗前相比较。采用SPSS13.0统计软件处理。同一指标的组间差异采用成组t检验,同一指标的前后比较采用配对t检验,两指标间采用线性相关分析。P＜0.05为差异有统计学意义。结果OSAHS组呼吸暂停低通气指数（AHI apnea hypopnea index）、夜间最低SaO₂及平均SaO₂与正常对照组有明显差别（P＜0.01）,且血清IL-6水平明显高于正常对照组（P＜0.01）。OSAHS组血清IL-6水平与睡眠呼吸暂停低通气指数（AHI）呈正相关（r=0.733,P＜0.01）;与夜间最低SaO₂,平均最低SaO₂呈负相关（分别r=-0.793,P＜0.01;r=-0.759,P＜0.01）。经过7天nCPAP治疗后,OSAHS患者自觉症状明显改善,AHI、夜间最低SaO₂及平均SaO₂也得到明显改善,血清IL-6水平较之治疗前明显下降（P＜0.01）。结论血清IL-6水平与OSAHS密切相关,且其做为炎性因子可能预示着心血管并发症的危险性,而nCPAP治疗可能降低这个危险因素,对患者心血管系统起到保护作用。更多还原

【Abstract】 Purpose:To explore the change of the serum interleukin-6 level in patients with obstructive sleep apnea hypopnea syndrom(OSAHS),and to study the effects of nasal continuous positive airway pressure on interleukin-6(IL-6)in serum of patients with obstructive sleep apnea hypopnea syndrome,and to explore the protection of nCPAP to the cardiovascular system of the patients of OSAHS.Methods:Before and seven days after the therapy ofnCPAP,serum IL-6,the lowest and average SaO2 during nighttime and AHI was determined in the experimental group(n=26,AGE:49±8,BMI:29.37±1.82kg/m2)and compared with a normal control group(n=24,AGE:48±10,BMI:28.51±1.99kg/m2).Results:The level of serum IL-6,the lowest and average SaO2 during nighttime and AHI have significant difference in 2 groups(P＜0.01),Before treatment,there were significant positive correlation between IL-6 and AHI in OSAHS patients (r=0.733,P＜0.01).significant negative correlation between IL-6 and the lowest and average SaO2 during nighttime(r=-0.793,P＜0.01;r=-0.759,P＜0.01); After nCPAP(7d),the serum level of IL-6 of OSAHS patients have reduced significantly(P＜0.01).Conclusions:nCPAP can obviously decrease the level of serum IL-6 of OSAHS patients;therefore it may reduce the incidence of cardiovascular complication of OASHS patients,and protect their cardiovascular system.更多还原