阻塞性睡眠呼吸暂停综合征和重叠综合征患者的血浆内皮素变化的临床观察  

Clinical Observation of ET-1 in Patients with Obsteructive Sleep Apnea Syndrome and Overlap Syndrome

作　　者：叶胜兰[1] 李承红[1] 

机构地区：[1]江汉大学附属医院呼吸科,湖北武汉430015

出　　处：《江汉大学学报（自然科学版）》2011年第4期73-76,共4页Journal of Jianghan University：Natural Science Edition

基　　金：武汉市卫生局2010年度临床医学科研项目(武汉[2010]42号)

摘　　要：目的:探讨阻塞性睡眠呼吸暂停综合征(OSAS)以及OSAS合并慢性阻塞性肺疾病(以下称重叠综合征)患者的血浆内皮素(ET-1)的变化及其与睡眠呼吸紊乱的关系.方法:平行开放的方法选取患者80例,其中单纯OSAS患者40例(A组),重叠综合征患者40例(B组),以及同期健康体检者为对照组30例(C组),观察记录3组ET-1、呼吸暂停低通气指数(AHI)、夜间睡眠最低血氧饱和度(LSaO2)的变化.结果:(1)治疗前A、B两组ET-1、AHI均高于正常对照组(C组),P<0.05,其中B组最高;A、B组LSaO2低于正常对照组,B组最低;(2)治疗前、后相比,A、B两组ET-1、AHI、LSaO2差异均有统计学意义,P<0.05,而且治疗后A、B两组相比差异有统计学意义,P<0.05;其中B组ET-1、AHI明显降低,LSaO2明显升高;(3)治疗前、后A、B组患者ET-1与AHI呈正相关,与平均血氧饱和度呈负相关.结论:重叠综合征患者因血浆内皮素增加、气道阻力增高而加重睡眠呼吸紊乱和夜间低氧血症.内皮素可作为重叠综合征患者判断病情的较好临床指标,在呼吸科领域具有广泛的应用前景,值得临床推广.Objective：To study endothelial-1（ET-1） in patients with obstructive sleep apnea syndrome（OSAS） and OSAS combining with chronic obstructive pulmonary disease（overlap syndrome）,and to investigate the relation between ET-1 change and sleep-disordered breathing.Methods：80 subjects were divided into two groups： the group with OSAS（group A,40 patients）,the group with overlap syndrome（group B,40 patients）,the control group（group C,30 patients）.The changes of ET-1,apnea hypopnea index（AHI） and the lowest oxygen saturation（LSaO2） at night were compared in three groups.Results： Before the treatment,ET-1 and AHI in group A and B were signifycantly higher than those in control group（group C） P 0.05,and they were highest in group B.LSaO2 in group A and B were lower than those in control group,and they were lowest in group B.Before and after the treatment,there were signifycant differences for ET-1,AHI and LSaO2 in group A and B（P 0.05）.Futhermore,after the treatment,there was a sig-nifycant difference between group A and B.In group B,ET-1,AHI decreased,and LSaO2 in-creased obviously.ET-1 was related to AHI,and positively related to LSaO2 in group A and B.Conclusions：The increases of ET-1 and airway resistance aggravate sleep-disordered breathing and nocturnal hypoxemia for overlap syndrome patients.ET-1 is a good clinical index to judge the disease.It has a wide application prospect and deserves the clinical expansion.

关 键 词：阻塞性睡眠呼吸暂停综合征 重叠综合征 内皮素 呼吸暂停低通气指数 

分 类 号：R56[医药卫生—呼吸系统] R766.43[医药卫生—内科学]