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目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆食欲素A水平以及手术治疗对血浆食欲素A水平的影响。方法:对54例经PSG确诊的重度OSAHS患者(OSAHS组)行UPPP加舌骨悬吊术,另选择20例年龄、性别、BMI等均相匹配的健康者作为对照(对照组)。采用层析及放射免疫测定法,测定OSAHS患者术前、术后6个月血浆食欲素A水平,分析其与AHI、MAI及最低SaO2的关系及术前、术后血浆食欲素A水平的变化。结果:OSAHS组血浆食欲素A水平显著高于对照组(P<0.01),且与AHI、MAI呈正相关(r=0.658,0.464,均P<0.05),与最低SaO2呈负相关(r=-0.543,P<0.01),54例OSAHS患者术后6个月血浆食欲素A水平明显低于术前(P<0.01),且这种差异与BMI无关。结论:OSAHS患者血浆食欲素A水平升高,其原因可能与夜间反复多发作呼吸暂停及低氧血症有关,有效的手术治疗可使血浆食欲素A水平下降。
Objective: To investigate the plasma levels of orexin-A in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and the effect of surgical treatment on plasma orexin-A levels. Methods: Fifty-four patients with severe OSAHS diagnosed by PSG (OSAHS group) underwent UPPP plus hypospadial suspension. Another 20 healthy subjects matched for age, gender and BMI were selected as the control group (control group). The levels of plasma orexin A levels in OSAHS patients before and 6 months after operation were determined by means of chromatography and radioimmunoassay. The changes of the levels of plasma orexin-A levels before and after surgery were compared with those of AHI, MAI and lowest SaO2 . Results: The level of plasma orexin A in OSAHS group was significantly higher than that in control group (P <0.01), and positively correlated with AHI and MAI (r = 0.658, 0.464, all P <0.05) 0.543, P <0.01). The level of plasma orexin A in 54 OSAHS patients at 6 months after operation was significantly lower than that before operation (P <0.01), and the difference was not related to BMI. CONCLUSIONS: The increase of plasma orexin-A level in patients with OSAHS may be related to repeated episodes of apnea and hypoxemia during nighttime. Effective surgical treatment may decrease the level of plasma orexin-A.