OSAHS患者nCPAP治疗前后血管活性物质变化与血压的关系  

Relation between blood pressure and variation of plasma ET-1,NO,TXA_2 and PGI_2 in patients with OSAHS before and after nCPAP treatment

作　　者：杨朝[1] 张群慧[1] 张锦[2] 

机构地区：[1]烟台毓璜顶医院,山东烟台264000 [2]宁夏医学院附属医院

出　　处：《山东医药》2007年第31期4-6,共3页Shandong Medical Journal

摘　　要：目的观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清内皮素(ET-1)、一氧化氮(NO)及血栓素A2(TXA2)与前列环素I2(PGI2)失衡和血压的关系及经鼻持续气道内正压通气(nCPAP)的治疗作用。方法选择OSAHS无原发性高血压(EH)者(A组)、OSAHS合并EH者(B组)、正常对照(C组),三组均行多导睡眠呼吸监测,用袖带加压法观察血压,测定三组血浆ET-1、6-酮-PGF1α、TXB2、NO水平。结果与C组比较,A、B组nCPAP治疗前睡眠呼吸暂停低通气指数(AHI)、ET-1/NO、TXB2/6-酮-PGF1α增高,最低SaO2下降;nCPAP治疗后则情况相反,与治疗前比较差异有统计学意义(P<0.05)。A组ET-1/NO、TXB2/6-酮-PGF1α分别与AHI和最低SaO2明显相关,B组MBP分别与ET-1/NO、TXB2/6-酮-PGF1α、AHI及最低SaO2明显相关。结论①OSAHS患者血管舒缩因子比例失衡可能在OSAHS合并EH中起一定作用。②nCPAP治疗OSAHS合并EH有确切疗效。[ Objective] To observe the relation between the level of plasma ET-1, NO, TXA2 , PGI2 in obstructive sleep apnea-hypopnea syndrome （OSAHS） and blood pleasure , and to observe the therapeutic action of nasal continuous positive airway pressure （nCPAP）. [Methods] OSAHS patients without essential hypertension （A group）,with essential hypertension （ B group）, and healthy control subjects （ C group）were detected. Overnight polyzomnographic recordings were performed in all recruits. The blood pressure was observed by cuff technique. ET-1,6-keto-PGF1 -alpha, TXB2 and NO in blood samples were measured. [ Results] Compared with group C, AHI, ET-1/NO and TXB2/6-keto-PGF1-alpha increased and minimal SaO2 decreased significantly in group A and B before treatment （ P 〈 0.05 ）. After nCPAP therapy, AHI, ET-1/NO and TXB2/6-keto-PGFl-alpha decreased and minimal SaO2 increased significantly in A and B group（ P 〈 0, 05）. The differences between before and after treatment had statistical significance（ P 〈 0.05）. There was a good correlation between ET-1/NO, TXB2/6-keto-PGF1-alpha and AHI, minimal SaO2 respectively in group A, There was a good correlation between MBP and ET-1/NO , TXB2/6-keto-PGF1-alpha , AHI and minimal SaO2 in group B. [ Conclusions] （1） Sleep apnea induces 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.

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 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]