İnflamasyon ve OUAS (Obstrüktif uyku apne sendromu) arasındaki ilişkinin araştırılması
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Dosyalar
Tarih
2018
Yazarlar
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Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş ve Amaç: Obstrüktif uyku apne sendromu (OUAS); uyku sırasında tekrarlayan tam (apne) veya parsiyel (hipopne) üst solunum yolu obstrüksiyonu epizotları ve sıklıkla kan O2 saturasyonunda düşmenin eşlik ettiği bir sendromdur. Günümüzde çok sayıda değişik tipte uyku bozukluğu tanımlanmıştır. Bunlardan ortalama %1- 5 oranında görülme sıklığı ile en önemli yeri Obstrüktif Uyku Apne Sendromu almaktadır. Apne ve hipopne peryodları sonucunda hiperkarbi ve hipoksemi oluşmakta, buna bağlı olarak intratorasik basınç dalgalanmaları, baroreseptör disfonksiyonu, oksidatif stres ve endotel disfonksiyonu gibi birçok organ ve sistemi etkileyen patolojiler oluşmaktadır. Obstrüktif Uyku Apne Sendromu patogenezinde üst solunum yolunda (ÜSY) lokal olarak artmış olan inflamasyonun rolü bilinmekle birlikte, spontan olarak devam etmesi gereken düzenli soluk alıp vermelerin değişik şiddette azalması ile ortaya çıkan hipoksi, asfiksi, hiperkapni ve solunumsal asidozun lokal ve sistemik inflamasyon gelişmesine yol açtığı öngörülmektedir. Obstrüktif Uyku Apne Sendromu tanısında kullanılan altın standart yöntem PSG (Polisomnografi)'dir. Radyolojik olarak lateral baş-boyun grafisi, kısıtlı olarak BT ve MRG kullanılabilmektedir. Ancak hastalığın tanı ve takibinde kullanılabilecek herhangi bir biyokimyasal belirteç henüz tanımlanmamıştır. Planladığımız bu çalışma ile inflamatuar belirteçlerin OUAS'ndaki yeri, hastalığın tanısını koymada önemli olup-olmayacağı, aynı özelliklere sahip OUAS'lu hastalar ve sağlıklı gönüllüler arasındaki inflamasyon açısından benzerlik ya da farklılıklarının değerlendirilmesi amaçlanmıştır. Hastalar ve Metot: Düzce Üniversitesi Tıp Fakültesi Hastanesi Uyku Laboratuvarı'nda Aralık 2016 - Temmuz 2017 tarihleri arasında ilk kez tanı amaçlı PSG uygulanan erişkin yaş grubundaki 165 hasta değerlendirilmiştir. Bu grup içerisinde uyku laboratuvarında PSG ile değerlendirildiği halde OUAS tanısı almayan ve çalışma kriterlerine uygun olan hastalar kontrol grubu olarak değerlendirildi (AHİ 5-15 Hafif, AHİ 15-30 Orta, AHİ >30 Ağır OUAS olarak tanımlanmaktadır). Hastalar AHİ<5 (normal) Grup 1, AHİ 5-15 (hafif) ve AHİ 15-30 (orta) Grup 2 ve AHİ>30 (ağır) Grup 3 olarak 3 gruba ayrıldı. Çalışmayı tamamlayan 165 hasta [Grup 1 (n=56), Grup 2 (n=69), Grup 3 (n=40)] istatiksel değerlendirmeye alındı. Bütün hastaların ve kontrol grubunun IL-6, TNF-?, neopterin ve YKL-40 serum düzeylerine bakıldı. Bulgular: IL-6, neopterin, YKL-40 değerleri açısından gruplar arasında anlamlı düzeyde fark vardı. Ancak TNF-? serum düzeyleri bakımından gruplar arasında anlamlı düzeyde fark gözlenmedi. Ağır grupta ölçülen IL-6 ortanca değeri, normal ve hafif-orta gruplarında ölçülen değerinden anlamlı düzeyde daha yüksekti. Ağır grupta ölçülen neopterin ortanca değeri, normal ve hafif-orta gruplarında ölçülen değerlerinden anlamlı düzeyde daha yüksekti. Ağır grupta ölçülen YKL-40 ortalama değeri, normal grupta ölçülen değerinden anlamlı düzeyde daha yüksekti (p<0,05). Sonuç: OUAS birçok organ ve sistemi etkileyen, yaşam kalitesini bozan ve günlük performansı düşüren mortalite ve morbiditeyi arttıran sistemik bir hastalıktır. Bu çalışmada OUAS hastalarında (özellikle ağır grup) inflamasyon belirteçlerinden IL-6, YKL-40 ve Neopterin serum düzeylerinin yükseldiği görüldü.
Introduction and Aim: OSAS (Obstructive Sleep Apnea Syndrome), is a syndrome that is characterised by recurrent events of complete (apnea) or partial (hipopne) upper respiratory tract obstruction episodes during sleep and is frequently accompanied by reduced in O2 saturation. Many different types of sleep disorders are identified so far. Obstructive Sleep Apnea Syndrome is the most important one because of its prevelance, which is an average of 1-5 As a result of apnea and hypopneas, hypercarbia and hypoxemia occur and resulting in pathologies affecting various organs and systems such as intratohoracic pressure fluctuations, baroreceptor dysfunction, oxidative stress and endothelial dysfunction. Although the role of locally increased inflammation in the URT (Upper Respratuar Tract) in the pathogenesis of obstructive sleep apnea syndrome is recognised, it is predicted that hypoxia, asphyxia, hypercapnia and respiratory acidosis, which occur with different levels of decline in regular breathing that should continue spontaneously, causes to local and systemic inflamation. PSG (polisomnography) is used as a golden standart method in diagnosing obstructive sleep apnea syndrome. Radiologically, lateral head and neck graph can be used, CT and MRI can be used in a limited way. However, any biochemical marker that could be used in the diagnosis and follow-up has not been identified yet. In this study that will be conducted, we aimed to evaluate the role of inflammatory markers in OSAS, whether they are important in the diagnosis of disease is important, and whether there are similarities or discrepancies between OSAS patients and healthy volunteers. Materials and Methods: A total of 165 patients in the adult age group who underwent diagnostic PSG for the first time between December 2016 and July 2017 were evaluated at Düzce University Medical Faculty Hospital, sleep laboratories. Patients in this group who were not diagnosed with OSAS during evaluation according to PSG criteria in the sleep laboratory were used as the control group (AHI 5-15 Mild, AHI 15-30 Moderate, AHI> 30 severe OSAS). Patients were divided into 3 groups: AHI <5 (normal) Group 1, AHI 5-15 (mild) and AHI 15-30 (middle) Group 2, and AHI> 30 (severe) Group 3. A total of 165 patients who completed the study [Group 1 (n = 56), Group 2 (n = 69), Group 3 (n = 40)] were included in the iv statistical evaluation. Serum levels of IL-6, TNF-?, Neopterin and YKL-40 were measured in all patients and control group Results: There was a significant difference between groups in terms of IL-6, neopterin, and YKL-40 values. However, there was no significant difference in serum TNF-? levels among the groups. The median IL-6 measured in the severe group was significantly higher than in the normal and mild-to-moderate groups. The neopterin median value measured in the severe group was significantly higher than the values measured in the normal and mild-to-moderate groups. The mean value of YKL-40 measured in the severe group was significantly higher than the value measured in the normal group (p <0,05). Conclusion: OSAS is a systemic disease that affects many organs and systems, impairs quality of life, and reduces the daily performance and increases morbidity and mortality. In this study, we found inflammatory markers of IL-6, YKL-40 and neopterin were elevated in OSAS patients (especially severe group).
Introduction and Aim: OSAS (Obstructive Sleep Apnea Syndrome), is a syndrome that is characterised by recurrent events of complete (apnea) or partial (hipopne) upper respiratory tract obstruction episodes during sleep and is frequently accompanied by reduced in O2 saturation. Many different types of sleep disorders are identified so far. Obstructive Sleep Apnea Syndrome is the most important one because of its prevelance, which is an average of 1-5 As a result of apnea and hypopneas, hypercarbia and hypoxemia occur and resulting in pathologies affecting various organs and systems such as intratohoracic pressure fluctuations, baroreceptor dysfunction, oxidative stress and endothelial dysfunction. Although the role of locally increased inflammation in the URT (Upper Respratuar Tract) in the pathogenesis of obstructive sleep apnea syndrome is recognised, it is predicted that hypoxia, asphyxia, hypercapnia and respiratory acidosis, which occur with different levels of decline in regular breathing that should continue spontaneously, causes to local and systemic inflamation. PSG (polisomnography) is used as a golden standart method in diagnosing obstructive sleep apnea syndrome. Radiologically, lateral head and neck graph can be used, CT and MRI can be used in a limited way. However, any biochemical marker that could be used in the diagnosis and follow-up has not been identified yet. In this study that will be conducted, we aimed to evaluate the role of inflammatory markers in OSAS, whether they are important in the diagnosis of disease is important, and whether there are similarities or discrepancies between OSAS patients and healthy volunteers. Materials and Methods: A total of 165 patients in the adult age group who underwent diagnostic PSG for the first time between December 2016 and July 2017 were evaluated at Düzce University Medical Faculty Hospital, sleep laboratories. Patients in this group who were not diagnosed with OSAS during evaluation according to PSG criteria in the sleep laboratory were used as the control group (AHI 5-15 Mild, AHI 15-30 Moderate, AHI> 30 severe OSAS). Patients were divided into 3 groups: AHI <5 (normal) Group 1, AHI 5-15 (mild) and AHI 15-30 (middle) Group 2, and AHI> 30 (severe) Group 3. A total of 165 patients who completed the study [Group 1 (n = 56), Group 2 (n = 69), Group 3 (n = 40)] were included in the iv statistical evaluation. Serum levels of IL-6, TNF-?, Neopterin and YKL-40 were measured in all patients and control group Results: There was a significant difference between groups in terms of IL-6, neopterin, and YKL-40 values. However, there was no significant difference in serum TNF-? levels among the groups. The median IL-6 measured in the severe group was significantly higher than in the normal and mild-to-moderate groups. The neopterin median value measured in the severe group was significantly higher than the values measured in the normal and mild-to-moderate groups. The mean value of YKL-40 measured in the severe group was significantly higher than the value measured in the normal group (p <0,05). Conclusion: OSAS is a systemic disease that affects many organs and systems, impairs quality of life, and reduces the daily performance and increases morbidity and mortality. In this study, we found inflammatory markers of IL-6, YKL-40 and neopterin were elevated in OSAS patients (especially severe group).
Açıklama
YÖK Tez No: 489989
Anahtar Kelimeler
Biyokimya, Biochemistry, Neopterine, Neopterine, Tümör nekroz faktörü-alfa, Tumor necrosis factor-alpha, Uyku apne sendromları, Sleep apnea syndromes, Uyku bozuklukları, Sleep disorders, İnflamasyon, Inflammation, İnterleukin 6, Interleukin 6, Obstrüktif Uyku Apne Sendromu, Neopterin, YKL-40, IL-6, TNF-a, İnflamasyon, Obstructive Sleep Apne Syndrome, Neopterin, YKL- 40, IL-6, TNF-a, Inflammation
