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目的:探讨老年OSAHS患者血清髓过氧化物酶(MPO)、细胞间黏附分子-1(ICAM-1)的表达及意义。方法:通过PSG确诊的老年OSAHS患者93例(OSAHS组),根据AHI分为重、中、轻3组,每组31例;选取31例健康老年体检者为对照组。ELISA法测定入组者外周血ICAM-1、MPO浓度;重度OSAHS患者综合治疗3个月后复测ICAM-1、MPO,分析ICAM-1、MPO与PSG相关指标的相关性。结果:(1)老年OSAHS患者体内ICAM-1、MPO浓度随病情严重程度增加逐渐上升(F=29.937,18.946;P<0.01);各组间ICAM-1、MPO浓度比较发现轻度组较对照组无显著差别(P>0.05),余各组相互比较均存在显著差别(P<0.05)。(2)OSAHS患者体内ICAM-1、MPO水平均与BMI、年龄无明显关联(P>0.05);ICAM-1与MPO水平改变呈正相关,二者均和LSaO_2呈负相关,与AHI呈正相关(P<0.01)。(3)31例重度老年患者经3个月综合治疗后外周血ICAM-1、MPO浓度及AHI显著降低,LSaO2明显上升,和治疗前比较均有显著差别(P<0.01)。结论:老年OSAHS患者体内ICAM-1、MPO水平上升可能为其并发心血管损害的机制之一;外周血ICAM-1、MPO水平的测定对老年OSAHS病情判断、疗效评估及合并心血管病风险的预测有一定参考价值。
Objective: To investigate the expression and significance of serum myeloperoxidase (MPO) and intercellular adhesion molecule-1 (ICAM-1) in elderly patients with OSAHS. Methods: Ninety-three elderly OSAHS patients (OSAHS group) diagnosed by PSG were divided into three groups according to AHI, including 3 in each group, 31 in each group, and 31 healthy controls were selected as control group. The concentration of ICAM-1 and MPO in the peripheral blood of the patients were measured by ELISA. ICAM-1 and MPO were measured in the patients with severe OSAHS 3 months later. The correlation between ICAM-1, MPO and PSG was analyzed. Results: (1) The concentrations of ICAM-1 and MPO in elderly patients with OSAHS increased gradually with the severity of illness (F = 29.937 and 18.946, P <0.01). The concentrations of ICAM-1 and MPO in each group were significantly higher than those in control group There was no significant difference between the two groups (P> 0.05). There were significant differences among the other groups (P <0.05). (2) The levels of ICAM-1 and MPO in patients with OSAHS were not significantly correlated with BMI and age (P> 0.05). ICAM-1 was positively correlated with MPO level, both of them were negatively correlated with LSaO_2 and positively correlated with AHI P <0.01). (3) The concentration of ICAM-1 and MPO, the level of AHI and the level of LSaO2 in peripheral blood of 31 severely senile patients after 3 months of combined treatment significantly decreased (P <0.01) compared with those before treatment. CONCLUSIONS: The increase of ICAM-1 and MPO levels in elderly patients with OSAHS may be one of the mechanisms of cardiovascular damage. The levels of ICAM-1 and MPO in the peripheral blood are useful for judging the severity of OSAHS and assessing the risk of cardiovascular diseases Forecast has a certain reference value.