阻塞性睡眠呼吸暂停低通气综合征对骨组织的影响

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (631 KB)
输出: BibTeX | EndNote (RIS)

摘要目的通过比较阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome ,OSAHS)患者与单纯鼾症者的骨密度(bone mineral density ,BMD),探讨OSAHS对骨组织的影响。方法选取126例男性鼾症患者,行多导睡眠监测(poly somno graphy ,PSG),根据呼吸暂停低通气指数(apnea hypopnea index ,AHI),分为单纯鼾症组(32例)、轻度OSAHS组(29例)、中度OSAHS组(35例)、重度OSAHS组(30例),采用双能X线吸收法(DXA)测定所有个体的部位BMD和T-BMD(T-BMD),分别将轻、中、重OSAHS组与单纯鼾症组比较。结果重度OSAHS组各部位BMD(P:0.006-0.045)和T-BMD(P=0.037)均低于单纯鼾症组和轻度OSAHS组,差异有统计学意义;重度OSAHS组的L_1-4整体BMD测量值均低于单纯鼾症组(P=0.008)和轻度OSAHS组(P=0.026),差异具有统计学意义;中度OSAHS组和重度OSAHS组的T-BMD测量值均明显低于单纯鼾症组(P=0.002和P=0.000),差异具有统计学意义; 126例AHI和T-BMD行相关和回归分析,AHI与T-BMD呈高度负相关(r=-0.283),经F显著性检验,F=10.831,P=0.001;差异具有统计学意义。结论 OSAHS是骨质疏松的危险因素,随着病情加重,BMD逐渐下降。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	段智娟
	李园园
	朱旭
	杨芸

关键词 ：阻塞性睡眠呼吸暂停低通气综合征, 骨密度, 骨质疏松

Abstract：Objective To study the impact of obstructive sleep apnea hypopnea syndrome(OSAHS) on bone issue. We compared the bone mineral density (BMD) between the patients with OSAHS and those who are simply snoring patients. Methods 126 male snoring patients are underwent the polysomnography(PSG). According to the apnea hypopnea index (AHI),they were divided into snoring group (32 cases),mild OSAHS group (29 cases), moderate OSAHS group(35 cases),and severe OSAHS group (30 cases); part BMD and total body BMD were determed. We compared mild, moderate and severe OSAHS groups with the simply snoring group, respectively. Results 1. Part BMD and total body BMD in the severe OSAHS group were lower than those in the snoring group, and the difference was statistically significant(P＜0.05). 2. Part BMD in the moderate OSAHS group was lower than in the snoring group,and the difference was statistically significant (P＜0.05). 3.Comparing mild OSAHS group with the snoring group, there was no significant difference(P＞0.05). Conclusion OSAHS is a risk factor of osteoporosis. The BMD in OSAHS patients decreases gradually with the aggravating of the illness.

Key words： obstructive sleep apnea-hypopnea syndrome bone mineral density osteoporosis

收稿日期: 2015-01-05

ZTFLH:

R58.1

通讯作者: 朱旭,E-mail:wjzhuxu@126.com

作者简介: 段智娟,硕士,主治医师,E-mail:jackychen123a@163.com

引用本文:

段智娟, 李园园, 朱旭, 杨芸. 阻塞性睡眠呼吸暂停低通气综合征对骨组织的影响[J]. 武警医学, 2015, 26(9): 869-872. DUAN Zhijuan,LI Yuanyuan, ZHU Xu, YANG Yun. A clinical study of bone mineral density in patients with obstructive sleep apnea hypopnea syndrome. Med. J. Chin. Peop. Armed Poli. Forc., 2015, 26(9): 869-872.

链接本文:

http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2015/V26/I9/869

[3]	Seifart C,Dempfle A,Plagens A,et al. TNF-alpha,TNF-beta,IL-6,and IL-10 promoter polymorphisms in patient’s with chronic obstructive pulmonary disease[J]. Tissue Antigens, 2005,65:93-100.
[1]	Papaioannou A, Parkinson W, Ferko N,et al. Prevalence of vertebral fractures among patients with chronic obstructive pulmonary disease in Canada[J]. Osteoporos Int, 2003, 14:913-917.
[2]	Raisz L G. Pathogenesis of osteoporosis: concepts, conflicts, and prospects [J]. Clin Invest, 2005,115:3318-3325.
[4]	中华医学会呼吸病分会睡眠呼吸病学组.中华医学会糖尿病学分会.阻塞性睡眠呼吸暂停与糖尿病专家共识[J]. 中华结核和呼吸杂志, 2010,33(6):326-330.
[5]	Reginster J Y, Burlet N. Osteoporosis: a still increasing prevalence[J]. Bone, 2011, 38(2):4-9.
[3]	Seifart C,Dempfle A,Plagens A,et al. TNF-alpha,TNF-beta,IL-6,and IL-10 promoter polymorphisms in patient’s with chronic obstructive pulmonary disease[J]. Tissue Antigens, 2005,65:93-100.
[6]	Arnett T R, Gibbons D C, Utting J C, et al. Hypoxia is a major stimulator of osteoclast formation and bone resorption[J].Cell Physiol,2013,196:2-8.
[4]	中华医学会呼吸病分会睡眠呼吸病学组.中华医学会糖尿病学分会.阻塞性睡眠呼吸暂停与糖尿病专家共识[J]. 中华结核和呼吸杂志, 2010,33(6):326-330.
[7]	顾九军,刘兴炎,盛俊东,等,缺氧对大鼠成骨细胞增殖及凋亡的影响[J].临床军医杂志, 2007, 35(2):171-173.
[8]	Papaioannou A, Parkinson W, Ferko N,et al. Prevalence of vertebral fractures among patients with chronic obstructive pulmonary disease in Canada[J].Osteoporos Int, 2009, 14:913-917.
[5]	Reginster J Y, Burlet N. Osteoporosis: a still increasing prevalence[J]. Bone, 2011, 38(2):4-9.
[9]	Ionescu A A, Schoon E. Osteoporosis in chronic obstructive pulmonary disease[J].Eur Respir Suppl,2010,46:64-75.
[6]	Arnett T R, Gibbons D C, Utting J C, et al. Hypoxia is a major stimulator of osteoclast formation and bone resorption[J].Cell Physiol,2013,196:2-8.
[10]	Ryan S, Taylor C T, McNicholas W T. Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome[J].Circulation, 2005,112:2660-2667.
[7]	顾九军,刘兴炎,盛俊东,等,缺氧对大鼠成骨细胞增殖及凋亡的影响[J].临床军医杂志, 2007, 35(2):171-173.
[11]	Yamauchi M, Kimura H. Oxidative stress in obstructive sleep apnea: putative pathways to the cardiovascular complications[J].Antioxid Redom Signal,2008,10(4):755-768.
[8]	Papaioannou A, Parkinson W, Ferko N,et al. Prevalence of vertebral fractures among patients with chronic obstructive pulmonary disease in Canada[J].Osteoporos Int, 2009, 14:913-917.
[12]	Mody N, Parhami F, Sarafian TA, et al. Oxidative stress modulates osteoblastie differentiation of vaseular and bone cells[J].Free Radie Biol Med,2011, 31(4):509-519.
[9]	Ionescu A A, Schoon E. Osteoporosis in chronic obstructive pulmonary disease[J].Eur Respir Suppl,2010,46:64-75.
[10]	Ryan S, Taylor C T, McNicholas W T. Selective activation of inflammatory pathways by intermittent hypoxia in obstructive sleep apnea syndrome[J].Circulation, 2005,112:2660-2667.
[11]	Yamauchi M, Kimura H. Oxidative stress in obstructive sleep apnea: putative pathways to the cardiovascular complications[J].Antioxid Redom Signal,2008,10(4):755-768.
[13]	Yang S, Madyastha P, Bingel S, et al. A new superoxide-generating oxidase in murine osteoclasts[J].Biol Chem,2009, 276(8):5452-5458.
[12]	Mody N, Parhami F, Sarafian TA, et al. Oxidative stress modulates osteoblastie differentiation of vaseular and bone cells[J].Free Radie Biol Med,2011, 31(4):509-519.
[13]	Yang S, Madyastha P, Bingel S, et al. A new superoxide-generating oxidase in murine osteoclasts[J].Biol Chem,2009, 276(8):5452-5458.