上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (4): 503-.doi: 10.3969/j.issn.1674-8115.2012.04.028

• 论著（临床研究） • 上一篇    下一篇

成年男性睡眠呼吸暂停综合征患者血清内脏脂肪素的变化

王 彦, 李庆云, 林莹妮, 张秀娟, 许华俊   

  1. 上海交通大学 |医学院附属瑞金医院呼吸科, 上海 200025
  • 出版日期:2012-04-28 发布日期:2012-04-27
  • 通讯作者: 李庆云, 电子信箱: liqingyun68@yahoo.com.cn。
  • 作者简介:王 彦（1985—）, 女, 硕士生；电子信箱: rain1wangyan@yahoo.com.cn。

Serum visfatin levels in adult male patients with obstructive sleep apnea-hypopnea syndrome

WANG Yan, LI Qing-yun, LIN Ying-ni, ZHANG Xiu-juan, XU Hua-jun   

  1. Department of Respiratory Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Online:2012-04-28 Published:2012-04-27

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摘要：

目的 研究成年男性阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者血清中内脏脂肪素（visfatin）水平的变化。方法 对73例习惯性打鼾成年男性行多导睡眠仪监测，根据呼吸暂停低通气指数（AHI）分为对照组（AHI< 5次/ h，n=13）、轻度OSAHS组（AHI 5~20次/ h，n=14）、中度OSAHS组（AHI 21~40次/ h，n=15）和重度OSAHS组（AHI> 40次/ h，n=31），采用酶联免疫吸附试验测定血清中visfatin水平。结果 ①不同严重度OSAHS组患者间血清visfatin表达水平有显著差异，且其水平随着疾病严重程度增加而升高[（0.23±0.11）、（0.24±0.19）、（0.29±0.24）和（0.48±0.32） ng/mL，F=4.704，P=0.005）]；其中重度组visfatin水平高于对照组、轻度组和中度组（t=2.751，P=0.009；t=2.563，P=0.014；t=2.014，P=0.05）。②visfatin水平与AHI、阻塞性睡眠呼吸暂停指数（OAI）、微觉醒指数、最低氧减持续时间以及血氧饱和度≤90%的时间占总监测时间的百分比（TS90）均呈显著正相关（P<0.01），而与夜间最低血氧饱和度（LSPO2）呈显著负相关（r=－0.435，P<0.01）。③控制体质量指数（BMI）和颈围因素后的偏相关分析显示，visfatin水平与OAI呈显著正相关（r=0.253，P=0.033）。④受试者工作特征（ROC）曲线分析显示，visfatin水平临界值为0.273 ng/mL时，区分OSAHS轻中度和重度的敏感度为77%、特异度为64%；ROC曲线下面积为0.733，95%CI为0.609~0.858（P=0.001）。结论 成年男性OSAHS患者血清visfatin水平与疾病严重程度一致，血清visfatin水平升高与OSAHS的发病存在一定的关联性。

关键词: 成年男性, 阻塞性睡眠呼吸暂停低通气综合征, 内脏脂肪素, 呼吸暂停低通气指数

Abstract:

Objective To investigate the levels of serum visfatin in adult male patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Seventy-three adult males with habitual snoring received polysonmographic examinations. Based on apnea hypopnea index (AHI), patients were divided into control group (AHI<5/h, n=13), mild OSAHS group (AHI 5-20/h, n=14), moderate group (AHI 21-40/h, n=15) and severe OSAHS group (AHI>40/h, n=31). The serum visfatin levels were measured by ELISA. Results ①There were significant differences in the serum visfatin levels among groups, and the serum visfatin levels increased with the severity of OSAHS [（0.23±0.11） ng/mL, （0.24±0.19） ng/mL, （0.29±0.24）ng/mL and （0.48±0.32） ng/mL, F=4.704，P=0.005）]. The serum visfatin level in severe OSAHS group was significantly higher than those in control group, mild OSAHS group and moderate group (t=2.751，P=0.009；t=2.563，P=0.014；t=2.014，P=0.05). ②Serum visfatin level was positively correlated with AHI, obstructive sleep apnea-index (OAI), micro-arousal index, duration of lowest oxygen desaturation and percentage of the total recorded time spent below 90% oxygen saturation level (TS90)(P<0.01), but was negatively correlated with lowest pulse oxygen saturation (LSPO2)(r=－0.435, P<0.01). ③Partial correlation analysis revealed that the serum visfatin level was positively correlated with OAI (r=0.253, P=0.033) after adjustment for body mass index (BMI) and neck circumference. ④Analysis of receiver operating characteristic (ROC) curve indicated that the cut-off value of serum visfatin was 0.273 ng/mL, and the sensitivity and specificity for differentiating mild and moderate OSAHS from severe OSAHS were 77% and 64% respectively. The area under the ROC curve was 0.733, and 95%CI was 0.609 to 0.858 (P=0.001). Conclusion Serum visfatin level increases with the severity of OSAHS in adult males, and the elevation of serum visfatin is related to the prevalence of OSAHS.

Key words: adult male, obstructive sleep apnea-hypopnea syndrome, visfatin, apnea-hypopnea index