Serum Interleukin-18 And Matrix Metalloproteinases-9 In Patients With Obstructive Sleep Apnea Hypopnea Syndrome

【Background】Obstructive sleep apnea hypopnea syndrom (OSAHS),is a group of syndrome ,it's character is the upper airway obstruction which is broken appear on sleep time , cause repeatedly apnea, disrupt the normal sleep structure accompanied by snoring, daytime sleepiness symptoms, and cause some pathophysiological change such as hypoxemia etc. OSAHS has been considered to the important health problems with high incidence, more and more medical experts pay much attention to it. OSAHS is closely relate to the morbidity and morality in heart cerebrovascular disease, is the independent risk factors in various heart cerebrovascular disease, but its exact pathogenesis is still not clear. The pathophysiological basis of heart cerebrovascular disease is atherosclerosis (AS). Study found that in recent years ,inflammation is the key factors in the process of atherosclerosis, the cytokines and cytokine network research and function evaluation which involved in inflammation response are got more and more attention, evaluation of inflammatory markers in serum has become an important tool for risk prediction of heart cerebrovascular disease. Interleukin 18 (IL - 18), is the most important proinflammatory factor in cytokine network; Matrix metalloproteinases-9 (MMP - 9), is a kind of endogenous protease. In recent years, both of them were found that is closely related with heart cerebrovascular disease, took part in the occurrence and development of atherosclerosis or even the entire process of atherosclerotic plaque ruptured, studies have pointed out, they may become the predictors of heart cerebrovascular disease.At present, the domestic and foreign several studies have found that the inflammatory factor of serum or plasma levels is higher in OSAHS patients, and therefore corollary inflammatory factor may be mediated the occurrence of disease of heart cerebrovascular disease in the OSAHS patients. But these studies have few samples, or not to match observed subjects BMI, not to investigate the relation for the two inflammatory factors, the research result has many uncertain factors.Therefore, this study select generally material matching OSAHS patients, divide into four groups( control subjects, mild OSAHS, moderate OSAHS, reverse OSAHS), choose Enzyme-linked immunosorbent detection methods to measure IL一18 and MMP-9 of serum levels and detect sleep apnea hypopnea syndrom (AHI) and minimum pulse blood oxygen saturation (MinSPO2), in order to explore the relation between inflammation and OSAHS,thus further research the pathogenesis in which OSAHS patients are more prone to heart cerebrovascular disease.【Objective】:To investigate the changes of interleukin一18(IL一18)and matrix metalloproteinases-9(MMP-9)of serum levels in obstructive sleep apnea hypopnea syndrome(OSAHS)patients without complications and explore the relation between inflammation and OSAHS,thus further research the pathogenesis in which OSAHS patients are more prone to heart cerebrovascular disease.【Methods】:All observed subjects were divided into 4 groups: control subjects, mild OSAHS, moderate OSAHS, reverse OSAHS. IL一18 and MMP-9 concentrations of serum were measured and were compared among 4 groups. Sleep—breathing parameters of the later three groups were also compared.Furthermore,to analyze the correlations between the two factors and sleep—breathing parameters in OSAHS.【Results】:1. The comparison to (mild, moderate, and severe) OSAHS patients and control subjects in age, weight, BMI, the difference was not statistically significant.2. Mild, moderate and severe OSAHS group serum IL-18 levels (22.60±3.79)ng/L, (31.42±2.80)ng/L and (43.22±5.60)ng/L were higher than the control group (10.68±4.90)ng/L(P<0.01). Mild, moderate and severe OSAHS group serum MMP-9 levels ( 1306.10±290.37 ) ng/L, ( 1981.78±392.57 ) ng/L and ( 3272.69±973.45 ) ng/L were higher than the control group(846.35±419.66)ng/L (P<0.01). The difference are statistically significant.3. The more formidable OSAHS severity, IL - 18 and MMP– 9 is higher, the difference was statistically significant. (P < 0.01)4. The serum IL-18 and MMP-9 levels of OSAHS group is positively correlated, difference is statistically significant. (r=0.818)(P<0.01)5. OSAHS group serum IL - 18, MMP - 9 levels and sleep apnea hypoventilation index (AHI) is a significant positive correlation.【(r=0.895),(r=0.835)】(P< 0.01)6. OSAHS group serum IL - 18, MMP - 9 levels and minimum pulse blood oxygen saturation(minSpo2)is a significant negative correlation.【(r=-0.600),(r= -0.517)】(P< 0.01)【Result】1. Each OSAHS group serum IL-18 and MMP-9 levels is significantly higher than the control group, show that IL - 18, MMP - 9 abnormalities expression and OSAHS illness related2. The comparison with serum IL-18 and MMP-9 levels in each OSAHS group is obvious difference. The more serious OSAHS illness, two factor expression level is higher.3. OSAHS group serum IL - 18, MMP - 9 levels and AHI is a significant positive correlation. OSAHS group serum IL-18, MMP-9 levels and minSpo2 is a significant negative correlation. It explain that the two factors are relate to OSAHS illness degree.4. The serum IL-18 and MMP-9 levels of OSAHS group is positively correlated, OSAHS was perhaps a inflammatory disease,and closely relate with IL一18 and MMP-9.