Long-Term Effect of Continuous Positive Airway Pressure Therapy on Inflammation Markers of Patients with Obstructive Sleep Apnea Syndrome
Long-Term Effect of Continuous Positive Airway Pressure Therapy on Inflammation Markers of Patients with Obstructive Sleep Apnea Syndrome
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DOI：
10.1093/sleep/32.4.537
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发表时间：
2009-04-01
期刊：
影响因子：
5.6
通讯作者：
Bouros, Demosthenes
中科院分区：
文献类型：
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作者：
Steiropoulos, Paschalis;Kotsianidis, Loannis;Bouros, Demosthenes
研究目的：有证据表明阻塞性睡眠呼吸暂停综合征（OSAS）患者存在免疫系统紊乱。然而，没有持续气道正压通气（CPAP）治疗对全身免疫力的长期影响的数据。因此，我们试图评估这种影响对各种免疫学参数在OSAS patients.Design：前瞻性病例系列。设置：睡眠单位的综合hospital.Patients：新诊断，不吸烟，否则健康的OSAS男性患者（n = 52）进行了评估诊断和6个月后CPAP治疗。根据6个月随访时对CPAP使用的依从性，将患者分为2组：A组（n = 32）：依从性良好（平均CPAP使用>= 4 h/night）; B组（n = 20）：依从性差（平均CPAP使用< 4 h/night）。测定淋巴细胞亚群百分比和绝对计数（流式细胞术）、血清TNF-α、IL-6和尿酸水平。两组的基线人体测量或睡眠特征无差异。在A组中，观察到应用CPAP后总淋巴细胞（P = 0.003）和CD 4（+）细胞（P = 0.001）的绝对计数显著降低，TNF-α水平（P = 0.001）和尿酸水平（P < 0.001）降低。相反，没有改变发生在任何测试参数在组B patients.Conclusions：选择性减少可溶性和细胞免疫反应因子，只有在那些OSAS患者表现出良好的依从性CPAP治疗提供了进一步的证据，持续的全身免疫过程中OSAS。
Study Objectives: Several lines of evidence suggest immune system derangement in obstructive sleep apnea syndrome (OSAS) patients. However, no data exist on the long-term effect of continuous positive airway pressure (CPAP) treatment on systemic immunity. Hence, we sought to evaluate this effect on various immunological parameters in OSAS patients.Design: Prospective case series.Setting: Sleep unit of a general hospital.Patients: Newly-diagnosed, nonsmoking, otherwise healthy OSAS male patients (n = 52) were evaluated on diagnosis and 6 months after CPAP treatment. According to compliance to CPAP use at 6-month follow-up, they were divided into 2 groups: group A (n = 32): good compliance (mean CPAP use >= 4 h/night); and group B (n = 20): poor compliance (mean CPAP use < 4 h/night).Interventions: N/AMeasurements and Results: Blood samples were obtained at baseline and at the 6-month follow-up. Percentage and absolute count of lymphocyte subsets (by flow cytometry), serum TNF-alpha, IL-6, and uric acid levels were measured. No differences were recorded regarding the baseline anthropometric or sleep characteristics of the 2 groups. In group A, a significant decrease in the absolute count of total lymphocytes (P = 0.003), and of CD4(+) cells (P = 0.001), and a decrease in TNF-alpha levels (P = 0.001) and uric acid levels (P < 0.001) was observed after CPAP application. On the contrary, no alterations occurred in any of the tested parameters in group B patients.Conclusions: The selective reduction of soluble and cellular immune response factors only in those OSAS patients who exhibited good compliance to CPAP therapy provides further evidence for an ongoing systemic immune process in OSAS.