阻塞性睡眠呼吸暂停低通气综合征患者血浆ET-1、NO水平的变化及nCPAP对其影响  

Variation of plasma ET-1 and NO in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) before and after nCPAP

作　　者：杨朝[1] 张锦[1] 

机构地区：[1]宁夏医学院附属医院呼吸科,宁夏银川750004

出　　处：《中国老年学杂志》2004年第9期793-795,共3页Chinese Journal of Gerontology

摘　　要：目的　观察阻塞性睡眠呼吸暂停低通气综合征 (OSAHS)患者经鼻持续气道内正压通气 (nCPAP)治疗前后血浆ET 1、NO水平的变化 ,并探讨其临床意义。方法　选择OSAHS无EH者 (A组 ) ,OSAHS合并EH者 (B组 ) ,正常对照 (C组 ) ,三组行PSG监测。用放免法测血浆ET 1 ,NO采用硝酸还原酶法。A、B两组施以nCPAP治疗。用袖带加压法观察血压。结果　①与C组相比 ,A组AHI、ET 1 /NO增高 ,最低SaO2 下降 ,治疗后情况相反 ;A组治疗前后ET 1 /NO分别与AHI、最低SaO2 均明显相关 (r分别为 0 40 8、- 0 569)。②与C组相比 ,B组MBP、AHI、ET 1 /NO增高 ,最低SaO2 下降 ,治疗后情况相反 ;B组治疗前后MBP分别与ET 1 /NO、AHI、最低SaO2 均明显相关 ,r分别为 0 439、0 51 5、- 0 455。结论　①OSAHS可引起血压升高 ,某些血管舒缩因子比例失衡可能在OSAHS合并EH中起一定的病理作用 ;Objective To observe the levels of plasma ET 1 and NO in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) before and after nasal continuous positive airway pressure (nCPAP) and to discuss their clinical significance.Methods We detected OSAHS patients without essential hypertension (EH) as A group, OSAHS patients with EH (B group) and healthy control subjects (C group)with polysomnographic (PSG). ET 1 and NO in blood samples were measured by radioimmunoassay and nitrate reductase, respectively. A and B group were treated using nCPAP therapy and the blood pressure was observed by cuff technique. Results ①Comparison with group C, AHI and ET 1/NO increased and minimal SaO 2 decreased significantly in group A. Three days after nCPAP therapy, AHI and ET 1/NO decreased and minimal SaO 2 returned significantly in A group. ET 1/NO was correlated with AHI and minimal SaO 2 significantly respectively in group A(R equaled 0.408, -0.569 respectively). ②Comparison with group C, MBP, AHI and ET 1/NO increased and minimal SaO 2 decreased significantly in group B. After three days treated using nCPAP, the situation was reversed; there is a good correlation between MBP and ET 1/NO, AHI, minimal SaO 2, respectively (R equaled 0.439, 0.515 and -0.455 respectively). Conclusions ① OSAHS makes blood pressure increase. Unbalance between vasoconstrictors and vasodilators may play a pathological role in the development of hypertension in OSAHS.② nCPAP benefits OSAHS with essential hypertension. It may prevent OSAHS patients from brain or cardiovascular complications.

关 键 词：内皮素 一氧化氮 阻塞性睡眠呼吸暂停低通气综合征 原发性高血压 经鼻持续气道内正压通气 

分 类 号：R563.8[医药卫生—呼吸系统]