论文部分内容阅读
目的:通过研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者UPPP前后皮质醇及促肾上腺皮质激素(ACTH)的变化,探讨OSAHS患者下丘脑-垂体-肾上腺轴激素水平的改变。方法:选择OSAHS患者30例行PSG检查及UPPP术,并于术前及术后6个月均以放射免疫法检测入睡时及晨起ACTH水平及入睡后每2h皮质醇(COR)血浆浓度测定,分析其变化关系。结果:OSAHS患者术前的COR水平明显高于术后,且分泌的节律发生改变〔术前入睡时COR(170.4±56.5)μg/L,0:00时COR(252.2±62.3)μg/L,2:00时COR(276.9±70.4)μg/L,4:00时COR(285.9±63.2)μg/L,晨起时COR(395.1±85.2)μg/L;术后入睡时COR(133.5±24.8)μg/L,0:00时COR(99.9±9.2)μg/L,2:00时COR(103.8±13.2)μg/L,4:00时COR(146.2±22.5)μg/L,晨起时COR(199.6±20.9)μg/L〕而ACTH的分泌差异无统计学意义;术前术后的平均血氧饱和度与平均觉醒时间呈负相关(r=-0.713)。结论:OSAHS患者的下丘脑-垂体-肾上腺轴水平异常,反馈调节紊乱,并与睡眠觉醒和夜间低氧有关。
Objective: To investigate the changes of corticosteroids and adrenocorticotropic hormone (ACTH) before and after UPPP in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and to explore the changes of hypothalamus-pituitary-adrenal axis hormone in patients with OSAHS. Methods: PSG and UPPP were performed in 30 patients with OSAHS. ACTH level at the time of falling asleep and the plasma concentrations of ACTH were measured by radioimmunoassay (RIA) at 6 and 6 months after operation, and plasma concentrations of COR were detected every 2 hours after falling asleep , Analyze its changing relationship. Results: The preoperative COR level in patients with OSAHS was significantly higher than that after operation and the rhythm of secretion was changed (COR (170.4 ± 56.5) μg / L before sleep onset, COR (252.2 ± 62.3) μg / L at 0:00, COR was 276.9 ± 70.4 μg / L at 2:00, COR was 285.9 ± 63.2 μg / L at 4:00, COR was 395.1 ± 85.2 μg / L at morning and COR was 133.5 ± 24.8 COR was 99.9 ± 9.2 μg / L at 0:00, COR was 103.8 ± 13.2 μg / L at 2:00, and COR was 146.2 ± 22.5 μg / L at 4:00, COR (199.6 ± 20.9) μg / L), while there was no significant difference in the secretion of ACTH between them. The average preoperative oxygen saturation was negatively correlated with the average awakening time (r = -0.713). Conclusions: Hypothalamus-pituitary-adrenal axis abnormalities in OSAHS patients are disturbed by feedback regulation and are associated with awakening of sleep and nocturnal hypoxia.