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目的探讨血清甲状腺激素、甲状腺转录因子-1(TTF-1)与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的相关性。方法回顾性分析2015年1月至12月在新疆维吾尔自治区人民医院高血压中心就诊的262例可疑OSAHS患者的临床资料。所有患者行多导睡眠(PSG)监测,根据呼吸暂停低通气指数(AHI)分为对照组(n=110)、轻度OSAHS组(n=56)、中度OSAHS组(n=47)和重度OSAHS组(n=49)。检测对照组和重度OSAHS组TTF-1水平,以及四组患者甲状腺功能5项;并分析其与OSAHS的相关性。结果四组患者在性别、饮酒率、腹围、体质指数(BMI)、高密度脂蛋白胆固醇(HDL-C)和甘油三酯的比较上,差异均有统计学意义(P均<0.01)。对照组与重度OSAHS组患者的TTF-1水平无明显差异(P>0.05);游离甲状腺素(FT4)水平在四组患者间差异有统计学意义(P<0.01),其中重度OSAHS组FT4水平较对照组、轻度OSAHS组和中度OSAHS组均明显升高(P均<0.05)。多元线性回归分析显示,男性、高BMI和高AHI可能是影响OSAHS患者FT4水平的危险因素(P<0.01,P<0.05)。结论 TTF-1不能作为OSAHS的潜在生物标志物。OSAHS可引起FT4的异常分泌,性别、BMI和AHI可能是OSAHS患者FT4水平变化的影响因素,推测OSAHS可能与甲状腺疾病存在一定的相关性。
Objective To investigate the relationship between serum thyroid hormone, thyroid transcription factor-1 (TTF-1) and obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods The clinical data of 262 suspected OSAHS patients who were treated in the hypertension center of People’s Hospital of Xinjiang Uyghur Autonomous Region from January to December 2015 were retrospectively analyzed. All patients underwent polysomnography (PSG) monitoring and were divided into control group (n = 110), mild OSAHS group (n = 56) and moderate OSAHS group (n = 47) according to apnea hypopnea index Severe OSAHS group (n = 49). The levels of TTF-1 in the control group and severe OSAHS group were measured, and the thyroid function in the four groups was analyzed. The correlation between TTF-1 level and OSAHS was analyzed. Results There were significant differences in gender, alcohol consumption, abdominal circumference, body mass index (BMI), high density lipoprotein cholesterol (HDL-C) and triglyceride between the four groups (all P <0.01). There was no significant difference in the level of TTF-1 between the control group and the severe OSAHS group (P> 0.05). The level of FT4 was significantly different between the four groups (P <0.01) Compared with the control group, mild OSAHS group and moderate OSAHS group were significantly increased (all P <0.05). Multivariate linear regression analysis showed that male, high BMI and high AHI may be the risk factors of FT4 in OSAHS patients (P <0.01, P <0.05). Conclusion TTF-1 can not be used as a potential biomarker for OSAHS. OSAHS can cause abnormal secretion of FT4. Gender, BMI and AHI may be the influencing factors of FT4 levels in OSAHS patients. It is speculated that OSAHS may have some correlation with thyroid diseases.