摘要目的 探讨妊娠合并阻塞性睡眠呼吸暂停低通气综合征( OSAHS)与血清中性粒细胞激活肽-78(ENA-78)和巨噬细胞移动抑制因子(MIF)的相关性及其意义.方法 选择妊娠合并OSAHS患者102例和正常妊娠36例行标准多导睡眠呼吸监测系统监测记录呼吸暂停低通气指数(AHI)；并根据AHI分为轻度OSAHS组36例,中度OSAHS组34例和重度OSAHS组32例.采用酶联免疫(ELISA)法检测血清ENA-78和MIF含量.结果 OSAHS合并高血压组AHI、MAP、ENA-78和MIF含量明显高于单纯OSAHS组(t=13.46,11.65,12.47,13.52,P均＜0.01)和正常妊娠组(t=16.72,15.31,16.35,17.43,P均＜0.01),单纯OSAHS组AHI、MAP、ENA-78和MIF含量明显高于正常妊娠组(t=8.92,9.27,10.24,10.23,P均＜0.01)；同时重度OSAHS患者的ENA-78和MIF含量明显高于中度OSAHS组,中度组明显高于轻度组,差异有统计学意义(P均＜0.01).其中OSAHS组患者AHI值与MAP、MIF、ENA-78呈正相关(r=0.75,0.71,0.68,P均＜0.01)；OSAHS组患者ENA-78值与MAP、MIF呈正相关(r =0.65,0.68,P均＜0.01).结论 妊娠合并OSAHS患者病情与ENA-78、MIF水平密切相关；妊娠合并OSAHS部分参与了妊娠期高血压疾病(HDCP)的病理过程.

abstractsObjective To investigate the correlation of serum epithelial neutrophil-activing peptide-78( ENA-78),macrophage migration inhibitory factor (MIF) with patients with pregnancy combined with obstructive sleep apnea hypopnea syndrome(OSAHS) and its significance.Methods One hundred and two pregnancy women combined with OSAHS and 36 healthy pregnancy women were randomly selected,and all night polysomnography ( PSG),apnea hypopnea index ( AHI ) were recorded.According to apnea hypopnea index (AHI),they were divided into three groups:36 patients were in mild OSAHS group,34 patients were in moderate OSAHS group and 32 patients were in severe OSAHS group.Serum ENA-78 and MIF levels were detected by enzyme-linked immunosorbent assay (ELISA),and simultaneous determination of mean arterial pressure (MAP).Results The leves of AHI,MAP,ENA-78 and MIF in OSAHS patients complicated with hypertension were significantly higher than those in patients with OSAHS only ( t =13.46,11.65,12.47,13.52,P all ＜0.01 ) and the controls ( t =16.72,15.31,16.35,17.43,P all ＜0.0l ).The levels of AHI、MAP、ENA-78 and MIF were higher in OSAHS group than those in healthy controls (t =8.92,9.27,10.24,10.23,Pall ＜0.01 ).Patients in severe OSAHS group had higher levels of ENA-78 and MIF than moderate OSAHS group,and moderate OSAHS group had higher levels of visfatin and MIF than mild OSAHS group( P ＜ 0.01 ).AHI was positively correlated with MAP,MIF,ENA-78 (r =0.75,0.71,0.68,Pall ＜0.01 ).ENA-78 was positively correlated with MAP and MIF (r =0.65,0.68,P all ＜ 0.01 ).Conclusions The condition of patients with pregnancy combined with OSAHS is closely related with the levels of ENA-78 and MIF.Pregnancy combined with OSAHS may take part in the pathological process of HDCP.