OSAHS患者经CPAP治疗后对内皮功能影响临床研究  

CPAP treatment on endothelial function of patients with OSAHS in clinical research

作　　者：冯志红[1] 聂秀红[1] 樊晓军[1] 张连国[1] 魏兵[1] 雒志明[1] 任魁[1] 高赏[1] 

机构地区：[1]首都医科大学宣武医院呼吸科,北京100053

出　　处：《国际呼吸杂志》2015年第11期831-835,共5页International Journal of Respiration

摘　　要：目的探讨持续气道正压通气（CPAP）1年后对OSAHS患者内皮功能的影响。方法经多导睡眠图（PSG）监测确诊为OSAHS组患者66例（男54例，女12例），中位年龄41（20～58）岁。正常对照组54例（男45例，女9例），中位年龄42（18～59）岁。OSAHS患者（62例）接受CPAP治疗，12个月后复查各项指标。各组均于PSG监测后采空腹静脉血，应用流式细胞仪检测内皮细胞凋亡（CDl46^AnnV＋）水平。结果与对照组比较，OSAHS组内皮细胞凋亡水平升高，差异有统计学意义（P值均〈0．01）。OSAHS组患者CDl46^AnnV＋水平与AHI、SLT0．9、LSAT、ODI呈显著正相关（r值分别0．73、0．61、0．66、0．67，P值均〈0．05），与saO2min呈显著负相关（r=-0．61，P〈0．01）。CPAP治疗1年后AHI、SLT0．9、LSAT、ODI下降及SaO2min升高，CDl46^AnnV＋水平下降，差异均有统计学意义（P值均〈0．05）。结论0sAHs患者血管内皮功能受损的发病机制与血管内皮细胞凋亡异常相关。CPAP治疗可显著改善OSAHS患者缺氧、降低CDl46^AnnV＋水平，改善血管内皮功能。Objective To investigate the changes of circulating apoptotic endtothelial cells andobserve the effects of continuous positive airway pressure （CPAP） on circulating apoptotic endothelial cells in patients with obstructive sleep apnemhypopnea syndrome （OSAHS）. Methods Sixty-six subjects,who were diagnosed by polysomnography （PSG） as OSAHS （54 men and 12 women）,median age 41 （20-58） years and control group （AHI〈5,45 men and 9 women） , median age 42 （18-59） years,were studied. All patients except 4 with OSAHS were accepted CPAP and rechecked PSG after a year. All the blood samples were obtained after PSG. The percentage of circulating apoptotic endothelial cells was performed by flow cytometry （FCM）. Results Circulating apoptotic endothelial cells in OSAHS group were higher than those in control group （all P 〈0.01）. The level of circulating apoptotic endothelial cells was positively correlated with AHI, SLT0.9, LSAT and ODI （ r = 0.73, 0. 61, 0.66, 0.67 respectively,all P 〈0.05） and was negatively correlated with SaO2min （r =-0.61, P〈0.01）. Circulating apoptotic endothelial cells were significantly reduced and the parameters including AHI, SLT0.9, LSAT, ODI, and SaO2 min were significantly improved （all P〈0.05） in patients with OSAHS after a year by CPAP therapy. Conclusions The pathogenesis of OSAHS patients with impaired endothelial function is associated with abnormal vascular endothelial cell apoptosis. CPAP treatment can significantly improve hypoxia in patients with OSAHS, reduce CDl46^AnnV＋ levels, improve endothelial function.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 内皮细胞 凋亡 持续气道正压通气 

分 类 号：R544.1[医药卫生—心血管疾病]