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目的观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血小板衍生生长因子(PDGF)水平的变化,探讨其与OSAHS及心血管疾病的关系。方法采用酶联免疫吸附试验(ELISA)检测2004年6月至2005年6月就诊的40例OSAHS患者和20例健康对照者外周血血清中血小板衍生生长因子-BB(PDGF-BB)水平,用逆转录聚合酶链反应(RT-PCR)技术检测受试者外周血单个核细胞PDGF-B mRNA水平,同时观察18例重度OSAHS患者经鼻持续气道正压通气(nCPAP)治疗前后相关指标的变化。结果OSAHS患者各组与对照组血清PDGF-BB水平[OSAHS轻、中、重组与对照组分别为(477±115)、(736±126)、(1 046±137)、(151±19)ng／L]及外周血单个核细胞PDGF-B mRNA水平[OSAHS轻、中、重组与对照组分别为(0．7±0．1)、(1．0±0．2)、(1．3±0．2)、(0．4±0．1)灰度面积比值]比较差异有统计学意义(F=102．59、58．75,P均<0．01);进一步分析与患者平均动脉压、睡眠呼吸暂停低通气指数(AHI)、小于90％脉搏容积血氧饱和度(SpO2)时间占总睡眠时间百分比、呼吸暂停时间占总睡眠时间百分比呈正相关(r值分别为0．657、0．682、0．683和0．551,P均<0．05),与平均SpO2、最低SpO2呈负相关(r值分别为-0．583及-0．576,P均<0．05)。经nCPAP治疗后,重度OSAHS患者血清PDGF-BB水平及外周血单个核细胞PDGF-B mRNA水平明显降低[治疗前分别为(1 046±137)ng／L、(1．3±0．2)灰度面积比值,治疗后分别为(699±130) ng／L、(0．7±0．2)灰度面积比值],但仍高于对照组[(151±19)ng/L、(0．4±0．1)灰度面积比值],差异有统计学意义(F=82．21、154．24,P均<0．01)。结论OSAHS患者PDGF水平明显增加,PDGF可能参与了OSAHS的病理过程,特别是OSAHS引发心血管疾病的相关病理生理过程。
Objective To observe the changes of platelet-derived growth factor (PDGF) level in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and to explore its relationship with OSAHS and cardiovascular diseases. Methods The levels of platelet-derived growth factor-BB (PDGF-BB) in 40 peripheral blood serum from 40 patients with OSAHS and 20 healthy controls from June 2004 to June 2005 were detected by enzyme-linked immunosorbent assay (ELISA) The levels of PDGF-B mRNA in peripheral blood mononuclear cells were detected by reverse transcription-polymerase chain reaction (RT-PCR). The levels of PDGF-B mRNA in peripheral blood mononuclear cells of 18 patients with severe OSAHS before and after nasal continuous positive airway pressure (nCPAP) Variety. Results Serum levels of PDGF-BB in OSAHS patients were significantly higher than those in OSAHS patients (477 ± 115, 736 ± 126, (1046 ± 137, 151 ± 19, / L] and PDGF-B mRNA levels in peripheral blood mononuclear cells [OSAHS were (0.7 ± 0.1), (1.0 ± 0.2), (1.3 ± 0.2), (0.4 ± 0.1) gray area ratio] was statistically significant difference (F = 102.59,58.75, P <0.01); further analysis and the average patient Arterial pressure, sleep apnea hypopnea index (AHI), pulse oxygen saturation (SpO2) less than 90% of total sleep time, and apnea time were positively correlated with the percentage of total sleep time (r values were 0.657 , 0.682,0.683 and 0.551, P <0.05), and negatively correlated with average SpO2 and lowest SpO2 (r values were -0.583 and -0.576 respectively, all P <0. 05). The serum level of PDGF-BB and the level of PDGF-B mRNA in peripheral blood mononuclear cells of patients with severe OSAHS after treatment with nCPAP were significantly lower than those before treatment [before treatment (1.046 ± 137) ng / L, (1.3 ± 0.2) (699 ± 130) ng / L and (0.7 ± 0.2) gray area ratio after treatment, respectively], but still higher than that of the control group [(151 ± 19) ng / L, 0.4 ± 0.1) gray area ratio], the difference was statistically significant (F = 82.21,154.24, P <0.01). Conclusions The level of PDGF in patients with OSAHS is significantly increased. PDGF may be involved in the pathological process of OSAHS, especially the pathophysiological process of OSAHS-induced cardiovascular diseases.