IL-17在肺栓塞合并阻塞性睡眠呼吸暂停低通气综合征患者体内表达情况及其临床意义
Expression of IL-17 in Patients with Both PE and OSAHS and Its Clinical Significance
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摘要: 目的 观察肺栓塞 (pulmonary embolism, PE) 合并阻塞性睡眠呼吸暂停低通气综合征 (obstructive sleep apnea-hypopnea syndrome, OSAHS) 患者静脉血白介素17 (Interleukin-17, IL-17) 表达情况与动脉血气水平及血浆D-二聚体的关系.方法 2017年1月至2017年8月期间在昆明医科大学第二附属医院呼吸内科一病区住院治疗的PE患者63例以及合并发病者20例为研究对象.对其进行睡眠呼吸检测, 测定D-二聚体, 动脉血气水平, 静脉血血清IL-17水平.结果 PE合并OSAHS患者动脉血氧分压 (PO2) 下降为 (42.15±3.27) mmHg, 较单纯PE患者 (66.58±9.30) mmHg明显降低 (P<0.05) , 血浆D-二聚体 (D-D) 以及IL-17量分别从1.75 mmol/L升高至3.5 mmol/L (P<0.05) 、7.55 mmol/L升高至54.85 mmol/L (P<0.05) ;IL-17表达量在合并发病组中增加, 且与血液高凝状态及体重指数 (BMI) 呈正相关, 与动脉血氧分压则相反 (P<0.05) .结论 IL-17与患者的多项指标间互相关联, 提示其可能在PE合并OSASH的发生发展中起到一定作用, 可能作为一项筛检合并发病患者的指标.
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关键词:
- 肺栓塞 /
- 阻塞性睡眠呼吸暂停低通气综合征 /
- 白介素-17 /
- 血浆D-二聚体
Abstract: Objective To observe the relationship of IL-17 and arterial blood gas, fibrin fragment D (D-D) in patients with both pulmonary embolism (PE) and obstructive sleep apnea-hypopnea syndrome (OSAHS) . Methods We collected 20 patients with both PE and OSAHS and 43 patients with only PE who hospitalized in the first ward of pneumology department of the Second Affiliated Hospital of Kunming Medical University, then measured D-D, IL-17 in venous blood and arterial blood gas and recorded them to analysis.Re s ults PO2 in patients with both PE and OSAHS was significantly lower than that in patients with only PE, while D-D and IL-17 of the latter were markedly lesser than the former. Conclus ions The expression of IL-17 between the 2 groups of patients has statistically significant difference. What's more, the expression of IL-17 is positively associated with hypercoagulability and Body Mass Index (BMI) , and the result shows a negative relation between arterial blood oxygen partial pressure and IL-17, suggesting that IL-17 may be relate to the common progress of PE and OSASH. Thus, IL-17 can be used in the detection of patients with both PE and OSASH-
Key words:
- Pulmonary embolism /
- Sleep apnea syndromes /
- Interleukin-17 /
- fibrin fragment D
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[1] [1]STRATMANN G, GREGORY GA.Neurogenic and humoral vasoconstriction in acute pulmonary thromboembolism[J].Anesth Analg, 2003, 97 (2) :341-354. [2]赵梦华, 石建平, 田洪森.肺栓塞的病理生理研究现状[J].医学综述, 2004, 10 (10) :617-618. [3]刘晓婷.肺栓塞流行病学及危险因素与死亡相关因素的分析[D].长春:吉林大学 (硕士论文) , 2011. [4]韩芳.阻塞性睡眠呼吸暂停综合征的诊断及治疗[J].中华结核和呼吸杂志, 1998, 21 (8) :453-455. [5]黄晶晶, 张希龙.阻塞性睡眠呼吸暂停中上气道的生物力学[J].国际呼吸杂志, 2006, 26 (12) :884-887. [6]赵立军.睡眠呼吸暂停综合征的发病及损害机制[J].国外医学.呼吸系统分册, 2002, 22 (3) :113-115. [7]薛玉文, 杜以明, 王德尚.睡眠呼吸暂停综合征研究现状[J].山东医药, 2004, 44 (25) :63-64. [8]张立强.阻塞性阻塞性睡眠呼吸暂停低通气综合征与肺血栓栓塞症的关系[J].中华临床医师杂志 (电子版) , 2013, 7 (21) :9413-9415. [9]张向峰, 丁少芳, 朱光发, 等.24例合并肺血栓栓塞症的阻塞性阻塞性睡眠呼吸暂停低通气综合征患者临床特点及治疗分析[J].中国呼吸与危重监护杂志, 2011, 10 (6) :568-571. [10]俞卓伟, 保志军, 阮清伟, 等.氧化应激-炎症-衰老及其与Apo E基因相关性研究进展[J].生理学报, 2013, 65 (3) :338-346. [11]王春, 秦少博, 李萍.炎症与血管内皮损伤研究进展[J].心血管病学进展, 2015, 36 (1) :89-92. [12]周仲伟, 邹俊.阻塞性阻塞性睡眠呼吸暂停低通气综合征合并肺栓塞的临床特点分析[J].华西医学, 2014, 29 (10) :1801-1804. [13] 王重阳.阻塞性阻塞性睡眠呼吸暂停低通气综合征与肺血栓栓塞症的相关性[D].长春:吉林大学 (硕士论文) , 2016. [14] [14]HARRINGTON L E, HATTON R D, MANGAN P R, et al.Interleukin 17-producing CD4+effector T cells develop via a lineage distinct from the T helper 1 and 2 lineages[J].Nat Immunol, 2005, 6 (11) :1123-1132. [15] [15]KOMIYAMA Y S, NAKAE T, MATSUKI A, et al.IL-17 plays an important role in the devepmental autoimmune encephalomyelitis[J].J Immunol, 2006, 177 (1) :566-573. [16]王彬.Treg/Th17特征性细胞因子在下肢深静脉血栓形成中作用探讨[A].中华中医药学会.中华中医药学会周围血管病分会第五届学术大会暨黑龙江省中医周围血管病2013年学术讨论会学术论文集[C].中华中医药学会, 2013:5. [17]张颖, 李廷谦.白介素-17与呼吸系统疾病研究进展[J].国际呼吸杂志, 2006, 26 (10) :771-773. [18]葛丽荞, 明婷, 郑建云, 等.IL-17在OSAHS患者血清及组织中的测定及意义[J].广东医学, 2013, 34 (20) :3138-3141. [19] 中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性阻塞性睡眠呼吸暂停低通气综合征诊治指南 (2011年修订版) [J].中华结核和呼吸杂志, 2012, 35 (1) :9-12. [20] [20]TORBICKI A, PERRIER A, KONSTANTINIDES S, et al.Guidelines on the diagnosis and management of acute pulmonary embolism:the task force for the diagnosis and management of acute pulmonary embolism of the european society of cardiology (ESC) [J].European Heart Journal, 2014, 35 (43) :3033-3069. [21] [21]ALBANESI C 1, CAVANI A, GIROLOMONI G.IL-17is produced by nickel-specific T lymphocytes and regulates ICAM-1 expression and chemokine production in human keratinocytes:synergistic or antagonist effects with IFN-gamma and TNF-alpha[J].Journal of Immunology, 1999, 162 (1) :494-502. [22]伍海伦.肺栓塞患者D-D二聚体水平分析[J].中国实用医药, 2012, 7 (17) :50-51. [23]张宏洁.睡眠呼吸暂停综合征患者血浆血栓调节蛋白及D-二聚体变化的初步分析[D].汕头:汕头大学 (硕士论文) , 2010.
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