实用医学杂志 ›› 2023, Vol. 39 ›› Issue (6): 719-723.doi: 10.3969/j.issn.1006⁃5725.2023.06.011

• 临床研究 • 上一篇    下一篇

血清SUMO特异性蛋白酶1/低氧诱导因子⁃1α通路对阻塞性睡眠呼吸暂停低通气综合征患者心血管事件结局的预测价值 

贾远航 谭小武 陈林 涂容芳 周芳    

  1. 南华大学衡阳医学院附属第二医院呼吸与危重症医学科(湖南衡阳 421001)

  • 出版日期:2023-03-25 发布日期:2023-03-25
  • 通讯作者: 周芳 E⁃mail:932659965@qq.com
  • 基金资助:
    湖南省卫生健康委科研课题(编号:202203024555)

Predictive value of SENP ⁃1/HIF ⁃1α pathway on cardiovascular events in patients with obstructive sleep apnea hypopnea syndrome

JIA Yuanhang,TAN Xiaowu,CHEN Lin,TU Rongfang,ZHOU Fang.   

  1. Department of Respiratory and Critical Care Medicinethe Second Affiliated HospitalHengyang Medical SchoolUniversity of South ChinaHengyang 421001China. 
  • Online:2023-03-25 Published:2023-03-25
  • Contact: ZHOU Fang E⁃mail:932659965@qq.com

摘要:

目的 探讨血清 SUMO 特异性蛋白酶 1(SENP⁃1)/低氧诱导因子⁃1α(HIF⁃1α)通路对阻塞性 睡眠呼吸暂停低通气综合征(OSAHS)患者发生心血管事件(CVE)结局的预测价值。方法 选取 2018 1 月至 2021 3 月于医院确诊为 OSAHS 的男性患者 80 例,根据睡眠呼吸暂停低通气指数(AHI)将其分为轻 度组(43 例)、中度组(22 例)和重度组(15 例),另选择同期在本院体检中心进行体检的 43 例正常健康男性 为正常组。另外,根据随访1年期间内是否发生心血管事件(CVE)将80例OSAHS 患者分为CVE 组(28例) 和非CVE组(52例)。比较患者临床基线资料、常规生化指标;采用ELISA法检测患者血清中SENP⁃1/HIF⁃1α 通路相关蛋白 SENP⁃1、HIF⁃1α VEGF 水平;采用多因素 logistic 回归分析 OSAHS 患者发生 CVE 的危险因 素;采用受试者工作特征(ROC)曲线分析血清 SENP⁃1、HIF⁃1α、VEGF 水平对 OSAHS 患者发生 CVE 的预测 价值。结果 与轻度组比较,中度组和重度组患者体质指数、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、 三酰甘油、血肌酐、AHI及Ts90%值均显著升高(P < 0.05),LSpO2值显著降低(P < 0.05),其中重度组最为显著 P < 0.05)。与轻度组比较,中度组和重度组患者血清中SENP⁃1、HIF⁃1α、VEGF水平明显升高(P < 0.05),其 中重度组最为显著;与非CVE组比较,CVE组患者血清中SENP⁃1、HIF⁃1α、VEGF 水平明显升高(P < 0.05)。 多因素 logistic 回归分析显示,血清 SENP⁃1、HIF⁃1α、VEGF 水平是 OSAHS 患者发生 CVE 的独立危险因素 OR = 1.133、1.090、1.066,均 P < 0.05)。ROC 曲线分析显示,血清 SENP⁃1、HIF⁃1α、VEGF 水平对 OSAHS 者发生 CVE 均有预测价值,ROC 曲线下面积分别为 0.890、0.837、0.802(P < 0.05)。结论 血清中 SENP⁃1 HIF⁃1α、VEGF 水平升高是OSAHS 患者发生CVE 的独立危险因素,对OSAHS 患者发生CVE 具有预测价值。

关键词:

血清 SUMO 特异性蛋白酶 1, 阻塞性睡眠呼吸暂停低通气综合征, 心血管事件, 险因素, 诊断价值

Abstract:

Objective To investigate the predictive value of SUMO specific protease 1(SENP⁃1)/hypoxia inducible factor⁃1(HIF⁃1α)pathway on the outcome of cardiovascular events(CVE)in patients with obstructive sleep apnea⁃hypopnea syndrome(OSAHS). Methods Eighty male patients diagnosed as OSAHS in our hospital from January 2018 to March 2021 were selected and divided into mild group(43 patients),moderate group(22 patients)and severe group(15 patients). At the same time,43 normal healthy men who had physical examination in the physical examination center of our hospital were selected as the normal group. In addition,80 OSAHS patients were divided into CVE group(28 cases)and non CVE group(52 cases)according to whether cardiovascular events (CVE)occurred during the 1⁃year follow⁃up period. Clinical baseline data and routine biochemical indexes of patients were collected;serum SENP⁃1,HIF⁃1α and VEGF of SENP⁃1/HIF⁃1α signaling pathway were detected by ELISA assay;multivariate logistic regression was used to analyze the risk factors of CVE in OSAHS patients ROC analysis of serum SENP⁃1,HIF⁃1α and VEGF level to predict on the occurrence of CVE in OSAHS patients. Results Compared with those in the mild group,the body mass index,alanine aminotransferase,glutamic oxalo⁃acetic transaminase,triglyceride,serum creatinine,AHI and Ts90% value in the moderate group and severe group were significantly increased(P < 0.05),and LSpO2 value was significantly decreased(P < 0.05),especially significantly in the severe group(P < 0.05). Compared with that in the mild group,serum SENP⁃1,HIF⁃1α and VEGF level in the moderate group and severe group were significantly higher(P < 0.05),especially higher in the severe group(P < 0.05);serum SENP ⁃1,HIF ⁃1α and VEGF level in CVE group was significantly higher than that in non CVE group(P < 0.05). Multivariate logistic regression analysis showed that serum SENP⁃1,HIF⁃1α and VEGF level were independent risk factors for CVE in OSAHS patients(OR = 1.133,1.090,and 1.066 respectively all P < 0.05). ROC curve analysis showed that serum SENP⁃1,HIF⁃1α and VEGF level had predictive value for the occurrence of CVE in OSAHS patients,and the area under ROC curve was 0.890,0.837,and 0.802 respectively (P < 0.05). Conclusion Serum SENP⁃1,HIF⁃1α and VEGF level are independent risk factors for the occurrence of CVE in OSAHS patients,which can predict the occurrence of CVE in OSAHS patients.

Key words: serum SUMO specific proteinase 1 , obstructive sleep apnea?hypopnea syndrome , cardio? vascular events , risk factors , diagnostic value