老年冠心病合并阻塞性睡眠呼吸暂停综合征患者ghrelin/obestatin比值的变化及意义

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目的探讨老年冠心病合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者胃饥饿素(ghrelin)/肥胖抑制素(obestatin)比值变化及临床意义。方法收集2014年1月—2015年12月在余姚市人民医院确诊的冠心病患者112例作为研究对象,根据是否合并OSAHS分为冠心病合并OSAHS组(48例)和单纯冠心病组(64例),选择同期健康志愿者40例作为对照组。采用ELISA法测定血清ghrelin、obestatin水平。根据冠脉造影结果采用Gensini积分评估冠脉病变程度,使用多导睡眠图(PSG)监测确诊OSAHS。结果冠心病合并OSAHS组、单纯冠心病组患者的ghrelin/obestatin比值显著低于对照组,差异均有统计学意义(P<0.05或P<0.01)。冠心病合并OSAHS组患者的Gensini积分明显高于单纯冠心病组,差异有统计学意义(P<0.05)。冠心病合并OSAHS组患者的ghrelin/obestatin比值与Gensini积分、AHI呈负相关。结论老年冠心病合并OSAHS患者的ghrelin/obestatin比值与冠状动脉病变程度密切相关。ghrelin/obestatin比值有可能作为预测老年冠心病合并OSAHS的预测指标之一。 Objective To investigate the changes of ghrelin / obestatin ratio in elderly patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and its clinical significance. Methods One hundred and twelve patients with coronary heart disease diagnosed in Yuyao People’s Hospital from January 2014 to December 2015 were enrolled in this study. According to whether they had OSAHS, they were divided into OSAHS group (48 cases) and coronary heart disease group (64 cases ), Select the same period of 40 healthy volunteers as a control group. Serum ghrelin and obestatin levels were measured by ELISA. Coronary lesions were evaluated by Gensini score based on coronary angiography results. OSAHS was confirmed by polysomnography (PSG). Results The ghrelin / obestatin ratio in patients with coronary heart disease complicated with OSAHS and patients with coronary heart disease was significantly lower than that in the control group (P <0.05 or P <0.01). The Gensini score of patients with coronary heart disease complicated with OSAHS was significantly higher than that of patients with coronary heart disease (P <0.05). The ghrelin / obestatin ratio in patients with coronary heart disease and OSAHS group was negatively correlated with Gensini score and AHI. Conclusion The ghrelin / obestatin ratio in elderly patients with coronary heart disease and OSAHS is closely related to the severity of coronary artery disease. The ghrelin / obestatin ratio may be used as a predictor of OSAHS in elderly patients with coronary heart disease.
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