Xie C B, Huang X Q, Wu P, Luo X, He J, Zeng J F, Wang W, Tang Y Y
Department of Otolaryngology Head and Neck Surgery,Xiangya Hospital,Central South University, Key Laboratory of Otolaryngology Major Disease Research of Hunan,Changsha,410008,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Apr;32(7):481-484. doi: 10.13201/j.issn.1001-1781.2018.07.001.
To investigate the expression and significance of serum insulinlike growth factor-1(IGF-1) in adult patients with obstructive sleep apnea hypopnea syndrome(OSAHS).One hundred and seven patients of OSAHS diagnosed with PSG were included in the observation group，which were divided into heavy, medium and light group according to AHI.Fifty case of healthy people without OSAHS were included in control group.Serum IGF-1 were measured by ELISA. Thirty patients of heavy OSAHS received surgery and CPAP treatment for three months,and were retested the levels of IGF-1 and PSG six months later.①With the increase of OSAHS severity, the levels of serum IGF-1 were gradually decreased (F=37.732,<0.01). There was no significant difference between mild group and healthy people (>0.05), while there was significant differences between the remaining groups (<0.01). ②Serum IGF-1 level has no correlation with BMI and age in OSAHS patients(>0.05), and negatively correlated with LSaO₂,and positively correlated with AHI (<0.01). ③Serum IGF-1 level［(46.56±3.74)μg/L］ increased slightly compared with those before treatment［(42.79±4.87）μg/L］ in 30 severe patients after treatment with 3 months CPAP and regimen (<0.01). Serum IGF-1 level［(56.61±5.46)μg/L］ increased significantly after treatment for six months; AHI level (18.72±7.36) was significantly lower than that before treatment (48.77±10.51), and LSaO₂［(87.42±8.61)%］ increased significantly than that before treatment［(68.33±10.24)%］.OSAHS patients with decreased serum IGF-1 level may be associated with concurrent insulin resistance. Surgery combined with more than half a year of CPAP treatment can significantly reduce AHI, improve the level of LSaO₂ and serum IGF-1. Serum IGF-1 levels could be used as a monitor of efficacy evaluation.
探讨血清胰岛素样生长因子-1（IGF-1）在成年阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者中的表达及意义。选取107例经多导睡眠图（PSG）确诊的OSAHS患者作为观察组，根据睡眠呼吸暂停低通气指数（AHI）分为重度、中度和轻度组。选取50例无OSAHS的健康人作为对照组。采用酶联免疫吸附测定法（ELISA）检测血清IGF-1水平。对30例重度OSAHS患者进行手术及持续气道正压通气（CPAP）治疗3个月，6个月后复查IGF-1水平及PSG。①随着OSAHS严重程度增加，血清IGF-1水平逐渐降低（F=37.732，P<0.01）。轻度组与健康人之间差异无统计学意义（P>0.05），其余各组间差异有统计学意义（P<0.01）。②OSAHS患者血清IGF-1水平与体质量指数（BMI）及年龄无相关性（P>0.05），与最低血氧饱和度（LSaO₂）呈负相关，与AHI呈正相关（P<0.01）。③30例重度患者经3个月CPAP治疗及相关方案治疗后，血清IGF-1水平［（46.56±3.74）μg/L］较治疗前［（42.79±4.87）μg/L］略有升高（P<0.01）。治疗6个月后血清IGF-1水平［（56.61±5.46）μg/L］显著升高；AHI水平（18.72±7.36）显著低于治疗前（48.77±10.51），LSaO₂［（87.42±8.61）%］显著高于治疗前［（68.33±10.24）%］。血清IGF-1水平降低的OSAHS患者可能存在并发胰岛素抵抗。手术联合半年以上CPAP治疗可显著降低AHI，提高LSaO₂及血清IGF-1水平。血清IGF-1水平可作为疗效评估的监测指标。
