外周血MMP-9及NF-κB在OSAHS合并高血压中的表达及其相关性研究

摘要

Objective To investigate the role of plasma matrix metalloproteinase-9 (MMP-9) and nuclear factor kappa B (NF-κB) in the pathogenesis of obstructive sleep apnea hypopnea syndrome (OSAHS) complicated with hypertension.Methods The patients were selected in the respiratory medicine and neurology of our hospital from January 2014 to June 2014.Polysomnography(PSG) monitoring was employed to assess the patient.All patients were divided into 3 groups,including snoring group(23 cases),OSAHS group(32 cases),OSAHS with hypertension group(31 cases).And then according to the hypertension stage,OSAHS with hypertension group was divided into 3 groups,including OSAHS with stage 1 hypertension group(9 cases),OSAHS with stage 2 hypertension group(9 cases),OSAHS with stage 3 hypertension group(13 cases).The plasma MMP-9 was measured by ELISA.The mRNA expression levels of MMP-9 and NF-κB were detected by real-time quantitative PCR.Results The levels of MMP-9 and MMP-9 mRNA and NF-κB mRNA in OSAHS with hypertension group were significantly higher than those of snoring group and OSAHS group and the differences were statistically significant(P<0.05).The expression of MMP-9,the MMP-9 and NF-κB mRNA expression of monocytes in OSAHS with stage 3 hypertension group was significantly higher than those of OSAHS with stage 1 hypertension group and OSAHS with stage 2 hypertension group and the differences were statistically significant(P<0.05).The plasma MMP-9 was positively correlated with AHI and oxygen desaturation index and negatively correlated with LSaO2(P<0.05).The plasma MMP-9 was positively correlated with the MMP-9 mRNA expression(P<0.05).The MMP-9 mRNA expression was positively correlated with the NF-κB mRNA expression(P<0.05).Conclusion The plasma concentrations of MMP-9,the MMP-9 and NF-κB mRNA expression of monocytes in OSAHS with hypertension patients was significantly high,which is associated with disease severity and degree of hypoxia.The MMP-9 might play an important role in the pathogenesis of OSAHS with hypertension and be regulated by NF-κB pathway.%目的 探讨血浆基质金属蛋白酶9(MMP-9)和核转录因子kappa B(NF-κB)在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压发病中的作用.方法 选取2014年1月至6月在该院呼吸内科及神经内科行多导睡眠监测的受试者,根据睡眠监测检查结果及是否合并高血压进行分组,鼾症组23 例,OSAHS组 32例,OSAHS合并高血压组31例;并根据高血压级别对OSAHS合并高血压组进行亚组分型,其中OSAHS合并高血压1级组9例,2级组9例,3级组13例.分别采用酶联免疫吸附试验(ELISA)和实时荧光定量PCR的方法检测血浆MMP-9水平及单个核细胞中 MMP-9 和 NF-κB基因的表达水平.结果 OSAHS合并高血压组血浆MMP-9水平、单个核细胞MMP-9 mRNA和NF-κB mRNA的表达水平均明显高于鼾症组和OSAHS组,差异有统计学意义(P<0.05).OSAHS合并高血压3级组血浆MMP-9水平、单个核细胞MMP-9 mRNA和NF-κB mRNA的表达水平均明显高于OSAHS合并高血压1级组及2级组,比较差异有统计学意义(P<0.05).血浆MMP-9水平、 MMP-9 mRNA及NF-κB mRNA的表达与呼吸暂停低通气指数(AHI)、氧减指数(ODI)呈正相关(P<0.05),与最低血氧饱和度(LSaO2)呈负相关(P<0.05).血浆MMP-9水平与单个核细胞MMP-9 mRNA的表达呈正相关(P<0.05).单个核细胞MMP-9 mRNA的表达与NF-κB mRNA的表达呈正相关(P<0.05).结论 血浆MMP-9水平、 MMP-9 mRNA及NF-κB mRNA的表达水平在OSAHS合并高血压患者中明显增高并与疾病的严重程度相关,MMP-9在OSAHS合并高血压发病中起着重要作用,可能受NF-κB通路的调节.