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持续气道正压通气及上气道手术对睡眠呼吸暂停患者呼出气冷凝液和血清生物标志物的影响

Effect of continuous positive airway pressure and upper airway surgery on exhaled breath condensate and serum biomarkers in patients with sleep apnea.

作者信息

Lloberes Patricia, Sánchez-Vidaurre Sara, Ferré Àlex, Cruz María Jesús, Lorente Juan, Sampol Gabriel, Morell Ferran, Muñoz Xavier

机构信息

Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España; Unidad del Sueño, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Calos III, Madrid, España.

Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Calos III, Madrid, España.

出版信息

Arch Bronconeumol. 2014 Oct;50(10):422-8. doi: 10.1016/j.arbres.2014.02.016. Epub 2014 Jun 8.

Abstract

INTRODUCTION

Studies on inflammation biomarkers in serum and in exhaled breath condensate (EBC) in obstructive sleep apnea (OSA) have shown conflicting results. The objective of this study is to assess EBC and serum biomarkers in OSA patients at baseline and after continuous positive airway pressure (CPAP) or upper airway surgery (UAS).

PATIENTS AND METHODS

Nine OSA patients referred for UAS were matched for anthropometric characteristics and apnea-hypopnea index with 20 patients receiving CPAP. pH, nitrite (NO2(-)), nitrate and interleukin 6 in EBC and NO2(-), nitrate, leukotriene B4 and interleukin 6 in serum were determined. EBC and serum samples were collected at baseline and 3 months after CPAP or UAS.

RESULTS

Patients' mean body mass index was 30 (range 24.9-40) kg/m(2). EBC biomarker levels at baseline were within normal range and did not differ significantly after CPAP or UAS. No significant changes were observed in the serum concentration of the biomarkers determined after CPAP but the serum concentration of NO2(-) increased significantly at 3 months after UAS (P=.0078).

CONCLUSION

In mildly obese OSA patients, EBC biomarkers of inflammation or oxidative stress were normal at baseline and remained unchanged 3 months after UAS or CPAP. Although UAS was not effective in terms of reducing OSA severity, it was associated with an increase in serum NO2(-).

摘要

引言

关于阻塞性睡眠呼吸暂停(OSA)患者血清和呼出气冷凝液(EBC)中炎症生物标志物的研究结果相互矛盾。本研究的目的是评估OSA患者在基线时以及接受持续气道正压通气(CPAP)或上气道手术(UAS)后的EBC和血清生物标志物。

患者与方法

9例因UAS前来就诊的OSA患者与20例接受CPAP治疗的患者在人体测量学特征和呼吸暂停低通气指数方面进行匹配。测定EBC中的pH值、亚硝酸盐(NO2(-))、硝酸盐和白细胞介素6以及血清中的NO2(-)、硝酸盐、白三烯B4和白细胞介素6。在基线时以及CPAP或UAS治疗3个月后采集EBC和血清样本。

结果

患者的平均体重指数为30(范围24.9 - 40)kg/m(2)。基线时EBC生物标志物水平在正常范围内,CPAP或UAS治疗后无显著差异。CPAP治疗后所测定的血清生物标志物浓度无显著变化,但UAS治疗3个月后血清NO2(-)浓度显著升高(P = 0.0078)。

结论

在轻度肥胖的OSA患者中,炎症或氧化应激的EBC生物标志物在基线时正常,UAS或CPAP治疗3个月后保持不变。尽管UAS在降低OSA严重程度方面无效,但它与血清NO2(-)升高有关。

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