阻塞性睡眠呼吸暂停综合征免疫网络及其与临床的相关性

目的探讨红细胞表面补体受体Ⅰ型(CR1)活性、红细胞表面CD58表达和血清中可溶性白细胞介素-2受体(SIL-2R)、白细胞介素-6(IL-6)水平在阻塞性睡眠呼吸暂停综合征(OSAS)中的作用、变化规律及其与疾病严重程度的关系。方法采用肿瘤红细胞花环法、流式细胞分析法及酶联免疫吸附法检测20例中、重度OSAS患者(研究组)及15例正常人(对照组)的红细胞CR1活性、CD58表达和血清中SIL-2R、IL-6水平。结果(1)研究组患者肿瘤红细胞花环率(ECR1CaRR)较正常对照组降低(P<0.05);CD58表达明显高于对照组(P<0.01)。(2)研究组患者SIL-2R及IL-6水平均明显高于对照组(P均<0.01)。(3)OSAS患者SIL-2R、IL-6与呼吸紊乱指数(AHI)无相关性(P均>0.05),与动脉血氧饱和度低于90%的时间占总睡眠时间百分比(SIT90%)均呈正相关(P均<0.01)。ECR1CaRR、CD58表达与SIT90%无相关性(P均>0.05)。结论血清中SIL-2R、IL-6水平变化与OSAS患者病情密切相关,可作为临床分度及评价疗效的指标;红细胞免疫功能与细胞因子间存在相互调节作用。

Study on the immune modulations of obstructive sleep apnea syndrome

Objective To investigate the effect of the activity of CR1, the expression of CD_ 58 , the level of soluble interleukin-2R (SIL-2R) and interleukin-6(IL-6) level in serum on obstructive sleep apnea syndrome (OSAS). Methods Select 20 OSAS cases in hospital and 15 healthy controls of the same age. Use flow cytometry and enzyme-linked immunosorbent assay(ELISA) to detect the activity of CR1, the expression of CD_ 58 and the level of SIL-2R, IL-6 in serum. Results (1)The erythrocytes cancer cell rosette(ECR1CaRR)of the OSAS group was lower than that of control group(P< 0.05 ).The expression of CD_ 58 was significantly higher in OSAS group than that of control group (P< 0.01 ).(2)The level of SIL-2R, IL-6 in serum of cases was significantly higher than that of controls(P<0.01).(3)There were no significant dependability between the level of SIL-2R,IL-6 in serum and AHI(P>0.05). There were significant positive dependability between the level of SIL-2R,IL-6 in serum and SIT90(P<0.01).There were no significant dependability between ECR1,the expression of CD_ 58 and AHI(P>0.05). Conclusions There are relations between the level of SIL-2R,IL-6 in serum and the condition of OSAS cases, which can be used to evaluate and define in clinical work,there is a accommodative role between erythrocyte immune function and some cytokines.