论文部分内容阅读
目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清瘦素水平以及悬雍垂腭咽成形术对瘦素水平的影响。方法对61例经过多道睡眠监测确诊的OSAHS患者行改良悬雍垂腭咽成形术。采用放射免疫测定法,测定OSAHS患者术前、术后以及20例年龄、体重指数相近的单纯打鼾患者(对照组)的血清瘦素水平,分析瘦素与呼吸暂停及低通气指数(AHI)、体重指数(BMI)的关系以及术前、术后血清瘦素水平的变化。结果OSAHS患者与对照组的血清瘦素水平( x±s)分别为(15 3±8 0)μg/L、(6 1±3 1)μg/L,差异有统计学意义(P<0 05)。在OSAHS患者中,轻度、中度、重度患者的血清瘦素水平分别为(9 8±2 1)μg/L、(14 2±6 7)μg/L、(19 3±7 9)μg/L,血清瘦素水平与阻塞程度呈正相关(r=0 68,P<0 01 )。61例中52例有效者术后6个月血清瘦素水平(7 0±1 3)μg/L,与术前(15 2±3 9)μg/L相比,差异有统计学意义(P<0 01),这种差异与BMI无关,而无效者(9例)血清瘦素水平无明显变化。结论OSAHS患者血清瘦素水平增高,且瘦素水平与睡眠呼吸暂停的程度有密切联系;悬雍垂腭咽成形术治疗有效者血清瘦素水平下降。呼吸暂停有可能是导致OSAHS患者体内瘦素水平增高的重要因素。
Objective To investigate the effects of serum leptin level and uvulopalatopharyngoplasty on leptin level in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Sixty-one OSAHS patients diagnosed by multi-channel sleep monitoring underwent modified uvulopalatopharyngoplasty. Radioimmunoassay was used to measure the serum levels of leptin in patients with OSAHS before and after surgery and in 20 patients with simple snoring of similar age and body mass index (control group). The levels of leptin, apnea and hypoglycemia index (AHI) Body mass index (BMI) and preoperative and postoperative serum leptin levels. Results The serum leptin levels of OSAHS patients and control group were (153 ± 8 0) μg / L and (61 ± 31) μg / L, respectively, with significant difference (P <0.05 ). In patients with OSAHS, serum leptin levels were (9 8 ± 21) μg / L, (14 2 ± 6 7) μg / L, (19 3 ± 7 9) μg / L, serum leptin levels and the degree of obstruction was positively correlated (r = 0 68, P <0.01). The serum leptin level in 6 out of 61 patients (70 ± 1 3) μg / L at 6 months after operation was significantly higher than that before operation (15 2 ± 39) μg / L, P <0 01), this difference has nothing to do with BMI, and ineffective (9 cases) no significant change in serum leptin levels. Conclusions Serum leptin level is increased in patients with OSAHS, and the level of leptin is closely related to the degree of sleep apnea. The level of serum leptin is decreased in patients with OSAHS. Apnea may be an important factor that leads to an increase in leptin levels in OSAHS patients.