Liu Y, Gu Y C, Tang Y, Lü X L, Chen H, Wu Q Z
*Department of Respiratory Medicine, Affiliated Wujiang Hospital of Nantong University, Suzhou 215200, China.
Zhonghua Yi Xue Za Zhi. 2016 Nov 29;96(44):3577-3581. doi: 10.3760/cma.j.issn.0376-2491.2016.44.009.
To explore the role and the mechanism of Th17/Treg in obstructive sleep apnea hypopnea syndrome (OSAHS). A total of 100 patients who completed polysomnography (PSG) in the sleep lab of Affiliated Wujiang Hospital of Nantong University from Mar. 2015 to Apr. 2016 were enrolled and divided into four groups (primary snoring as the control group, mild OSAHS, moderate OSAHS and severe OSAHS) according apnea hypopnea index (AHI). The proportion of Th17, Treg (of CD4 T cells) and the expression of interleukin (IL)-17A, IL-6 were detected and the relevant data were analyzed by the correlation analysis and the multiple stepwise regression analysis. Compared with the control group, the OSAHS patients had higher Th17% [(1.36±0.46)%, (1.68±0.30)%, (2.23±0.03)% vs (1.02±0.22)%], Th17/Treg [(0.22±0.07), (0.28±0.10), (0.29±0.00) vs (0.13±0.03)], IL-17A [(2.53±0.89), (2.99±1.96), (7.77±1.63) vs (1.45±0.78) ng/L], IL-6 [(6.14±4.37), (9.41±4.66), (12.58±6.65) vs (5.44±3.13) ng/L] and lower Treg% [(7.57±0.16)%, (6.46±1.57)%, (6.10±1.19)% vs (8.02±1.45)%] (all <0.05). A positive correlation could be seen between Th17%, Th17/Treg, IL-17A, IL-6 and AHI, oxygen desaturation index (ODI) respectively, there was a negative correlation between Th17%, Th17/Treg, IL-17A, IL-6 and the lowest oxygen saturation (SpO) (all <0.05). The proportion of Treg had a negative correlation with AHI or ODI and a positive correlation with the lowest SpO (all <0.05). The lowest SpO was the most important factor which could influence Th17%, Treg% and the radio of Th17/Treg. There is an imbalance of Th17/Treg in OSAHS. Therefore, Th17 and the relevant inflammatory cytokines may be involved in the occurrence and development of OSAHS.
探讨Th17/Treg在阻塞性睡眠呼吸暂停低通气综合征（OSAHS）中的作用及机制。选取2015年3月至2016年4月在南通大学附属吴江医院睡眠实验室完成多导睡眠图（PSG）检查的100例患者，根据呼吸暂停低通气指数（AHI）分为四组（单纯打鼾为对照组、轻度OSAHS组、中度OSAHS组和重度OSAHS组）。检测Th17、Treg（CD4⁺T细胞）比例及白细胞介素（IL）-17A、IL-6表达，并采用相关性分析和多元逐步回归分析对相关数据进行分析。与对照组相比，OSAHS患者Th17%[（1.36±0.46）%、（1.68±0.30）%、（2.23±0.03）% vs （1.02±0.22）%]、Th17/Treg[（0.22±0.07）、（0.28±0.10）、（0.29±0.00） vs （0.13±0.03）]、IL-17A[（2.53±0.89）、（2.99±1.96）、（7.�7±1.63） vs （1.45±0.78）ng/L]、IL-6[（6.14±4.37）、（9.41±4.66）、（12.58±6.65） vs （5.44±3.13）ng/L]更高，Treg%[（7.57±0.16）%、（6.46±1.57）%、（6.10±1.19）% vs （8.02±1.45）%]更低（均P<0.05）。Th17%、Th17/Treg、IL-17A、IL-6分别与AHI、氧减饱和度指数（ODI）呈正相关，与最低血氧饱和度（SpO₂）呈负相关（均P<0.05）。Treg比例与AHI或ODI呈负相关，与最低SpO₂呈正相关（均P<0.05）。最低SpO₂是影响Th17%、Treg%及Th17/Treg比值的最重要因素。OSAHS中存在Th17/Treg失衡。因此，Th17及相关炎性细胞因子可能参与了OSAHS的发生发展。
