Study Of Immuno Function Of The T Lymphocyte In The Patients With Obstructive Sleep Apnea Hypopnea Syndrome

Obstructive sleep apnea hypopnea syndrome (OSAHS) is a clinic syndrome charactered with repeated intermittent hypoxia during sleeping at night whether companied with hypercapnia or not. As the further recognition the incidence is rising and it becomes one of the focuses concerned by more and more researchers. However, few reports about the study of immuno function of the T lymphocyte in the patients with OSAHS had been found in the literature at home or in foreign.Objective: To study the changes of the T lymphocyte subsets and the shifts of Th1/Th2 in the patients with OSAHS.Methods: Consecutive 30 patients in or out of hospital more than 30 years old were enrolled and a 7 hour continuous polysomnography (PSG) monitoring was performed. The diagnosis was fit the guideline to the patients with OSAHS of Chinese Medicine Association (CMA). At the same time, 30 healthy volunteers, who were confirmed not with OSAHS by PSG monitoring, were selected as the control. The subjects with a chronic or acute infection, with diabetes, malignant tumor or with psychic or body trauma in near future were removed out by asking history and routine examine. There were no significant differences in age and gender construction between two groups. After 7 hours PSG monitoring 6mL veno-blood sample was collected at 7 o'clock in the morning. 2mL sample anticoagulated with EDTA was used to test the T subsets. Serum in the other 4mL was isolated and put aside at -20℃ to test interleukin 4(IL-4) and interferon gamma (IFN-γ) with enzyme linkedimmunosorbent assay (ELISA) in future.Results: 1.Compared with control, CD3+, CD4+and CD4+/CD8+was decreasedsignificantly in OSAHS from (7 3.40 ±7.67), (43.71±5.64) and(1 . 7 3 ±0 . 4 2)to(61.07±7.17),(31.41±6.21)and (1 . 1 8 ±0 . 3 7) (P<0.01)respectively;But CD8+ had no significant change. 2. The OSAHS group had a higher level of IFN-y [(9.26±2.82), (P<0.05)] than control (6.10±0.90) while the IL-4 had no significant change;IFN-y/IL-4 raised from (5.01±1.47) to (8.03±3.21), (P<0.05). 3.Changes of IFN-y> IL-4 and IFN-y/IL-4 in patients with various degree OSAHS indicated that a significant rising of the serum level of IFN-y and IFN-y/IL-4 had been taken among mild, moderate and severe group in turn, (P<0.05 or P<0.01) . 4. study of the correlation-ship among CD4+/CD8+ and severity related parameters in patients with OSAHS showed that CD4+/CD8+was correlated with AHI (r=-0.325,p<0.05) and the maximum time of apnoea (Timemax) (r=-0.337,p<0.05) negatively while with the Lowest arterial oxygen saturation (LSaO2) positively (r=0.354, p<0.05). 5. Study of the correlation-ship among IFN-y/IL-4 and severity related parameters in patients with OSAHS showed that IFN-y/IL-4 had a positive correlation-ship with AHI (r=0.463, p<0.01) and a negative with LSa,O2 (r=-0.335, p<0.05).Conclusion: l.The patients with OSAHS had changes in T subsets in which the CD4+ T lymphocyte and CD47CD8+ decreased while CD8+ T lymphocyte had no significant change. 2. The patients with OSAHS had a shift to Thl and Thl/Th2 increased significantly which may take a role in systemic damages of OSAHS .3. The shifts of Thl/Th2 and the decreasing of CD4+/CD8+ had significant correlation-ship with parameters reflected the severity of OSAHS such as AHI,LSaO2 and Timemax.