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  本文關鍵詞： 阻塞性睡眠呼吸暫停低通氣綜合征 醛固酮 肺泡表面活性物質(zhì)相關蛋白　出處：《新疆醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:探討阻塞性睡眠呼吸暫停低通氣綜合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者血漿醛固酮濃度(plasma aldosterone concentration,PAC)和血清肺表面活性物質(zhì)相關蛋白(SPs)水平的關系。方法:本研究為橫斷面研究,選取2013年4月至2013年12月在新疆維吾爾自治區(qū)人民醫(yī)院高血壓診療研究中心住院的OSAHS患者共86人。所有入選患者均行睡眠呼吸監(jiān)測(Polysomnography,PSG),查晨起坐位血漿醛固酮濃度,采用酶聯(lián)免疫吸附方法(ELISA)測定血清肺泡表面活性物質(zhì)相關蛋白(SPs,包括SP-A,SP-B,SP-C,SP-D)和涎液化糖鏈抗原(KL-6)濃度,并根據(jù)血漿醛固酮濃度水平分為高醛固酮(H-ALD)組(n=32)(PAC≥15ng/dl)和正常醛固酮(N-ALD)組(n=54)(PAC15ng/dl)。探討H-ALD組與N-ALD組的血漿醛固酮濃度和血清肺表面活性物質(zhì)相關蛋白水平的關系。結果:與N-ALD組相比,H-ALD組血清SP-B較低(40.10±5.76ng/L比43.16±6.89ng/L,P=0.038),血清SP-A/C/D水平在H-ALD組中均有下降趨勢,但未達到統(tǒng)計學意義,兩組間KL-6水平見到統(tǒng)計學意義的差異。相關分析顯示,控制呼吸暫停低通氣指數(shù)(apnea-hypopnea index,AHI)后,PAC與血清SP-B呈負相關(r=-0.361,P=0.043)。多元線性回歸分析顯示,PAC是血清SP-B的影響因素(t=-2.081,P=0.041)。結論:在OSAHS患者中,外周血清肺泡表面活性物質(zhì)相關蛋白SP-B下降可能與升高的血漿醛固酮濃度有關。升高的醛固酮可能會抑制肺泡內(nèi)SP-B的合成和分泌,表現(xiàn)為血清SP-B水平的下降。
[Abstract]:Objective: to investigate obstructive sleep apnea hypopnea syndrome in obstructive sleep apnea hypopnea syndrome. Plasma aldosterone concentration and plasma aldosterone concentration in patients with OSAHS. Methods: this study was a cross-sectional study. A total of 86 OSAHS patients were selected from April 2013 to December 2013 in the hypertension diagnosis and treatment research center of Xinjiang Uygur Autonomous region people's Hospital. Polysomnography. The plasma aldosterone concentration in the sitting position of PSG was investigated and the serum levels of pulmonary surfactant associated protein (SPsincluding SP-An SP-B) were determined by enzyme linked immunosorbent assay (Elisa). SP-Con SP-D) and salivary liquefaction sugar chain antigen (KL-6). According to the plasma aldosterone concentration, the plasma aldosterone concentration was divided into two groups: the high aldosterone H-ALD group and the normal aldosterone N-ALD group. To investigate the relationship between plasma aldosterone concentration and pulmonary surfactant related protein level in H-ALD group and N-ALD group. Results: compared with N-ALD group. The serum SP-B in H-ALD group was 40.10 鹵5.76ng / L vs 43.16 鹵6.89ng / L respectively. The level of serum SP-A/C/D decreased in H-ALD group, but did not reach statistical significance. There was a statistically significant difference between the two groups in the level of KL-6. After controlling apnea hypopnea index (apnea-hypopnea index), there was a negative correlation between SP-B and serum SP-B. The multivariate linear regression analysis showed that SP-B was the influential factor of serum SP-B. Conclusion: in patients with OSAHS, there is no significant difference between the two factors (P < 0. 043, P = 0. 043, P = 0. 043, P < 0. 043). The decrease of SP-B may be related to the increase of plasma aldosterone concentration, which may inhibit the synthesis and secretion of SP-B in the alveolar. The serum SP-B level decreased.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R766

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