目的探讨自动调节持续气道正压通气(auto-CPAP)治疗对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者呼出气冷凝液(EBC)和血清中瘦素水平的影响。方法根据多导睡眠监测确诊的42例中重度OSAHS患者,随机分为治疗组22例和对照组20例,对治疗组进行三个月auto-CPAP治疗,对治疗组和对照组患者均采取常规治疗,分别测定治疗组及对照组三个月前后EBC和血清中的瘦素。结果①治疗组患者EBC和血清中瘦素治疗前[(5.67±1.07)μg/L、(40.20±5.40)μg/L]高于治疗后[(3.75±1.09)μg/L、(30.46±5.82)μg/L](P〈0.01);②对照组患者EBC和血清中Lep治疗前为[(5.52±1.14)μg/L、(42.19±4.96)μg/L],治疗后为[(5.95±1.26)μg/L、(42.69±4.33)μg/L],治疗前后差异无统计学意义(P〉0.05);③OSAHS患者EBC和血清中瘦素水平与呼吸暂停低通气指数呈正相关(r=0.787,P〈0.01;r=0.775,P〈0.01),与最低血氧饱和度、平均血氧饱和度呈负相关(r=-0.829,P〈0.01;r=0.794,P〈0.01)、(r=-0.890,P〈0.01;r=-0.830,P〈0.01)。结论OSAHS患者存在高瘦素血症,auto-CPAP治疗可以改善OSAHS患者的高瘦素血症。
Objective To investigate the effect of auto-CPAP therapy on the concentrations of leptin in exhaled breath condensate and plasma in patients with obstructive sleep apnea-hypopnea syndrome ( OSAHS ). Methods 42 patients with moderate-to-severe OSAHS diagnosed by polysomnograpgy monitoring were randomly allocated to the active group ( n =22) or the control group ( n= 20) respectively. The active group received the treatment of three months' auto-CPAP and all of the subjects received general treatment. Leptin levels in EBC and plasma were measured by enzyme linked immunosorbent assay (ELISA) before and after 3 months. Results ①The concentrations of leptin in EBC and plasma in the active group before treatment [(5.67±1.07)μg/L, (40.20±5.40) μg/L] were higher than the after [(3.75±1.09) μg/L, (30.4,6±5.82) μg/L]. ②The concentrations of leptin in EBC and plasma in the control group before treatment were[(5.52±1.14)μg/L,(42.19±4. 96)μg/L] and were [(5.95±1.26) μg/L,(42.69±4.33)μg/L] after the treatment. But there was no statistical difference tetween the befqre and after the treatment. ③Leptin levels in plasma and EBC were positively related with apnea hypoventilation index(AHI), and were inversely related with the lowest blood oxygen saturation ( r =-0. 829, P 〈0.01, r =0. 794, P 〈0.01)and average blood oxygen saturation ( r = -0. 890, P 〈0.01. r = -0. 830, P 〈0 01). Conclusions The hyperleptinemia in OSAHS patients and can be improved by auto-CPAP treatment.