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目的探讨血清胱抑素C在帕金森病合并阻塞性睡眠呼吸暂停低通气综合征患者中表达水平的临床意义。方法选取2012年5月-2014年5月期间在某院呼吸内科就诊并完成多导睡眠监测的帕金森患者109例为研究对象,根据AHI将所有患者分成2组:帕金森病组51例和OSAHS合并帕金森病组58例。另选取同期检查的健康中老年人40名作为对照组。记录相关临床资料,检测所有研究对象生化指标、睡眠参数、运动功能以及Cys C水平,计量资料采用方差分析和两独立样本t检验;计数资料采用χ2检验,P<0.05说明差异具有统计学意义。结果帕金森病组患者的Cys C水平为(0.98±0.10)mg/L,OSAHS合并帕金森病组为(1.07±0.15)mg/L,对照组为(0.86±0.18)mg/L,三组间的比较差异有统计学意义(F=9.184,P=0.001);Cys C水平与氧减饱和度指数、血氧小于90%时间占睡眠总时间比例、AHI、呼吸相关微觉醒指数及H-Y分级呈正相关(r值分别为0.572、0.435、0.762、0.391、0.683,P值均<0.05)。将Cys C作为因变量,行线性回归提示AHI(B=0.051,P=0.012)、H-Y分级(B=0.113,P=0.024)是Cys C水平变化的重要影响因素。结论帕金森病患者Cys C水平升高,而OSAHS合并帕金森病的患者Cys C水平更高,其水平的高低与睡眠呼吸紊乱程度和帕金森病的严重程度有关。
Objective To investigate the clinical significance of serum cystatin C expression in patients with Parkinson’s disease complicated by obstructive sleep apnea-hypopnea syndrome. Methods A total of 109 patients with Parkinson’s disease treated in respiratory medicine department and completed polysomnography during the period from May 2012 to May 2014 were selected as study subjects. All patients were divided into two groups according to AHI: 51 patients with Parkinson’s disease and 58 patients with OSAHS complicated with Parkinson’s disease. In addition, 40 healthy middle-aged and elderly people were selected as the control group. The related clinical data were recorded and the biochemical indexes, sleep parameters, motor function and Cys C levels of all the subjects were tested. The measurement data were analyzed by ANOVA and two independent samples t test. The count data were analyzed byχ2 test. P <0.05 indicated the difference was statistically significant. Results The level of Cys C was (0.98 ± 0.10) mg / L in patients with Parkinson’s disease, (1.07 ± 0.15) mg / L in OSAHS with Parkinson’s disease, and (0.86 ± 0.18) mg / L in control group (F = 9.184, P = 0.001). The levels of Cys C and oxygen desaturation index, the proportion of time when blood oxygen was less than 90% of the total sleep time, AHI, respiration-related arousal index and HY classification (R values were 0.572,0.435,0.762,0.391,0.683, P <0.05). Linear regression of Cys C as a dependent variable suggested that AHI (B = 0.051, P = 0.012) and H-Y classification (B = 0.113, P = 0.024) were important influencing factors of Cys C level changes. Conclusions The level of Cys C in patients with Parkinson’s disease is elevated, while the level of Cys C in patients with OSAHS complicated with Parkinson’s disease is higher. The level of Cys C is related to the degree of sleep disordered breathing and the severity of Parkinson’s disease.