探討阻塞型睡眠呼吸中止症患者血中自由基及抗氧化能力與嚴重度及血液生化值之相關性

The relationship between the level of free radicals and antioxidant potential and the severity and the blood biochemical parameters in obstructive sleep apnea patients

尹邦啟(Pang-Chi In)

指導教授 ： 周芬碧

中山醫學大學/醫學院/生化暨生物科技研究所/碩士(2010年)

摘要

根據台灣睡眠醫學學會[TSSM；2006]統計，台灣至少有45萬人罹患阻塞型睡眠呼吸中止症(obstructive sleep apnea, OSA)，影響睡眠品質，容易引發心血管疾病，甚至於造成交通事故。OSA病患，所引起的缺氧再獲氧(Hypoxia-reoxygenation)現象，常伴隨大量的活性氧自由基(ROS)產生，而導致氧化壓力(oxidative stress)的形成。本研究目的探討OSA患者血中自由基及抗氧化能力與嚴重度及血液生化值之相關性。蒐集38位OSA門診病患，經由多功能生理睡眠檢查儀 (polysomnography；PSG)所獲得的睡眠呼吸障礙指數(Respiratory disturbance index；RDI )值、及臨床血液、生化數值，同時經由超微弱化學發光（Ultra-weak chemiluminescence；CLA）分析儀量測所獲得的全血中超氧陰離子(superoxide anion；•O2-)、全血中氫氧自由基(hydroxyl radical，•OH)、血漿中總抗氧化能力（Total radical-trapping antioxidant parameter ；TRAP），統計分析變數間的相關性。結果顯示，(•O2-)、(•OH)與RDI嚴重指數及各臨床檢驗數值，並沒有顯著的關連性(p>0.05)；另外TRAP與RDI、RBC、HCT、UA呈正相關(p<0.05)，而與ESR呈負相關(p<0.05)。本研究推論OSA患者可能經由自由基形成的氧化壓力活化發炎反應，影響體內的抗氧化能力；但另一方面同時也可能增強抗氧化能力，來平衡氧化壓力。至於引發的相關機制仍需進一步探討。

關鍵字

阻塞型睡眠呼吸中止症 ； 自由基 ； 抗氧化能力

並列摘要

According to Taiwan Society of Sleep Medicine [TSSM；2006] statistics, at least 450,000 people in Taiwan are suffered from Ostructive Sleep Apnea (OSA) Syndrome, which would affect sleeping quality, and potentially induce cardiovascular disease, even cause traffic accidents. OSA patients could induce Hypoxia-reoxygenation, that often accompanied with large volume of Reactive Oxygen Species (ROS) generation that result in oxidative stress. The purposes of this study are discussing the relationship between the level of free radicals and antioxidant potential in OSA patients, nevertheless, the severity and blood biochemical parameters are also discussed. Blood sample from 38 patients were collected, the sleep-disordered Respiratory Disturbance Index (RDI) values were obtained by Polysomnography (PSG) analyzer, clinical hematology and biochemistry values were determined. Whole blood superoxide anion(•O2-), hydroxyl radical(•OH), and plasma Total Radical-trapping Antioxidant Parameter (TRAP) values were obtained by Ultra-weak Chemiluminescence (CLA) analyzer, were also evaluated. The correlation between variables were statistical analysis. The results showed that there is no significant difference in (•O2-), (•OH), RDI severity and the value of clinical examination (p> 0.05). In contrast, TRAP, the RDI severity, red blood cells, hematocrit, uric acid were positive correlated (p <0.05); however, erythrocyte sedimentation rate was negative correlation (p <0.05). This study infered that OSA patients are suffered from oxidative stress, and activated the inflammatory response, therefore affecting the body's antioxidant capacity; but on the other hand, it may also enhance the antioxidant capacity to balance the oxidative stress. Further study on the associate mechanisms are needed.

並列關鍵字

obstructive sleep apnea ； free radical ； antioxidant potential

參考文獻

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