论文部分内容阅读
目的探讨经鼻持续气道正压通气(n CPAP)对脑血管病并中重度阻塞性呼吸睡眠暂停综合征(OSAS)患者基质金属蛋白酶9(MMP-9)、肿瘤坏死因子α(TNF-α)的影响。方法选取2011年7月—2012年7月雅安市人民医院收治的脑血管病患者68例,根据呼吸暂停低通气指数(AHI)分为轻度OSAS组和中重度OSAS组,每组34例;另选取同期在本院体检中心体检的健康成年人31例作为对照组。脑血管病患者均持续接受n CPAP治疗3个月,比较3组受试者血清MMP-9和TNF-α水平,轻度OSAS组和中重度OSAS组患者治疗后3个月及1、2、3年脑血管病复发率。结果轻度OSAS组、中重度OSAS组患者血清MMP-9水平高于对照组(P<0.05),而轻度OSAS组与中重度OSAS组患者血清MMP-9水平比较,差异无统计学意义(P>0.05)。3组受试者血清TNF-α水平比较,差异无统计学意义(P>0.05)。治疗后中重度OSAS组患者血清MMP-9水平、AHI低于治疗前(P<0.05),而血清TNF-α水平与治疗前比较,差异无统计学意义(P>0.05)。中重度OSAS组患者治疗后3个月及1、2、3年脑血管病复发率均低于轻度OSAS组(P<0.05)。结论 nCAPAP可有效降低脑血管病并中重度OSAS患者血清MMP-9水平,降低脑血管病复发率。
Objective To investigate the effect of nCPAP on the expression of matrix metalloproteinase 9 (MMP-9) and tumor necrosis factor α (TNF-α) in patients with cerebrovascular disease and severe obstructive sleep apnea syndrome (OSAS) )Impact. Methods Sixty - eight patients with cerebrovascular disease who were admitted to Ya’an People ’s Hospital from July 2011 to July 2012 were divided into mild OSAS group and moderate to severe OSAS group according to apnea hypopnea index (AHI), 34 cases in each group. Another select the same period in our hospital physical examination of 31 healthy adults as a control group. Patients with cerebrovascular disease were treated with n CPAP for 3 months. The levels of serum MMP-9 and TNF-α were compared between the 3 groups. The patients in the mild OSAS group and the moderate and severe OSAS group were treated at 3 months and 1, 2, 3 years recurrence rate of cerebrovascular disease. Results The levels of serum MMP-9 in mild OSAS group and moderate-severe OSAS group were higher than those in control group (P <0.05), while there was no significant difference in serum MMP-9 levels between mild OSAS group and moderate-severe OSAS group P> 0.05). There was no significant difference in serum TNF-α levels between the three groups (P> 0.05). Serum MMP-9 levels in patients with moderate-severe OSAS after treatment were lower than those before treatment (P <0.05), while serum TNF-α levels were not significantly different from those before treatment (P> 0.05). The recurrence rates of cerebrovascular disease in patients with moderate-severe OSAS at 3 months and 1, 2, and 3 years after treatment were lower than those in mild OSAS (P <0.05). Conclusion nCAPAP can effectively reduce the level of serum MMP-9 in patients with cerebrovascular disease and moderate-severe OSAS and reduce the recurrence rate of cerebrovascular disease.