氧自由基与阻塞性睡眠暂停低通气综合征患者细胞因子相关性

摘要

Objective To study the correlation between cytokines and oxygen free radicals and the effects on apnea-hypopnea index(AHI) and lowest SaO2% of the patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods 38 patients,hospitalized for OSAHS from June 2008 to May 2009,were divided into mild, mo derate and severe group according to AHI.15 healthy volunteers as controls. The concentration of interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor(TNF-α) in serum measured by Double-antibody sandwich ELISA and the superoxide anion(O2-) generation in neutrophils in peripheral blood measured by the method of the reduction of cytochrome C.We analyze the relationship between cytokines,superoxide anion and AHI,lowest SaO2%.Results The concentration of IL-6,IL-8,TNF-α in the moderate and severe group is significantly higher than in the mild and control group(P<0.01).The superoxide anion generation in three groups have positive correlation with AHI(r=0.659,0.651,0.642,respectively),compared with control group(P<0.01),and have negative correlation with SaO2%(r=-0.536,-0.529,-0.518,respectively),compared with control group(P<0.01).The superoxide anion in moderate and severe group have positive correlation with IL-6IL-8,TNF-α(r=0.548,0.585,0.686.P<0.01).Conclusion The inflammatory cells in moderate,severe OSAHS patients were activated,the release of oxidizing substances increased,leading to worsening lung function, endocrine,cardiovascular system damage.%目的 阻塞型睡眠呼吸暂停低通气综合征(OSAHS)患者细胞因子与氧自由基相关性及对呼吸暂停低通气指数(AHI)和最低SaO2%的影响.方法 选自2008年6月～2009年5月门诊和住院的OSAHS患者,根据AHI将38例OSAHS患者分为轻、中、重度三组,健康体检者15名作为对照.采用双抗体夹心ELISA法检测血清中白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子(TNF-α)的质量浓度.细胞色素C还原法测外周血中性粒细胞释放超氧阴离子(O2-)水平.并分析O2-水平与细胞因子及AHI和最低SaO2%的关系.结果 重、中度组IL-6、IL-8、TNF-α水平及外周血中性粒细胞释放O2 -量显著高于轻度和正常对照组(P＜0.01).重、中、轻度组患者外周血中性粒细胞释放O2 -水平与AHI水平呈明显正相关(r 分别为0.659、0.651、0.642,P均＜0.01)、与最低SaO2%水平呈明显负相关(r分别为-0.536、-0.529、-0.518,P均＜0.01).重、中度组患者外周血中性粒细胞释放O2-水平与血浆IL-6、IL-8、TNF-α浓度呈线性正相关(重度组r分别为0.795、0.776、0.792,中度组r为0.548、0.585、0.686,P均＜0.01).结论 OSAHS重、中度组患者炎症细胞在细胞因子等刺激下活化,释放氧化物质增多,导致OSAHS重、中度组患者肺功能恶化,内分泌、心血管系统损害可能起重要作用.