重度阻塞性睡眠呼吸暂停低通气综合征与高血压患者血管内皮功能和主动脉顺应性的相关性研究  

Relationship between vascular endothelial function and aortic compliance in patients with severe obstructive sleep apnea hypopnea syndrome and hypertension

作　　者：唐智[1,2] 黄翠怡 肖林[2] 何雅君[2] 吴莉[2] 王继群 涂智峰 

机构地区：[1]南方医科大学顺德医院耳鼻咽喉科,广东佛山528300 [2]南方医科大学顺德医院附属杏坛医院耳鼻咽喉科,广东佛山528325 [3]顺德新容齐医院耳鼻咽喉科,广东佛山528325

出　　处：《中国耳鼻咽喉头颈外科》2017年第7期375-378,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：广东省医学科学技术研究基金项目(A2015237);佛山市科技局医学类科技攻关项目(2015AB002013);顺德区卫计局医学科研立项(2015A009)联合资助

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与高血压患者血管内皮功能和主动脉顺应性的相关性。方法选取经多导睡眠图监测确诊为重度OSAHS的患者103例,其中55例为单纯OSAHS组,48例为OSAHS合并高血压组,同时选取20例原发性高血压患者为单纯高血压组,20例健康查体人员为对照组,利用彩色多普勒超声检测肱动脉血流介导的血管舒张功能(flowmediated diameter,FMD)以评价血管内皮功能状态,利用超声心动图检测患者主动脉顺应性的改变。结果 OSAHS合并高血压组的FMD、主动脉张力和主动脉膨胀性指数水平明显低于正常对照组、单纯高血压组和单纯OSAHS组(P<0.05);OSAHS合并高血压组的主动脉僵硬指数水平明显高于正常对照组、单纯高血压组和单纯OSAHS组(P<0.05);Spearman相关系数分析OSAHS合并高血压患者FMD与主动脉僵硬指数呈正相关,与主动脉张力及主动脉膨胀指数呈负相关;OSAHS合并高血压组的FMD、主动脉张力、主动脉膨胀指数和主动脉僵硬指数与AHI呈正相关(P<0.05),与LSa O2呈负相关(P<0.05)。结论 OSAHS与血管内皮功能失调和主动脉顺应性下降相关。合并高血压时,会显著影响血管内皮功能和主动脉顺应性。OSAHS严重程度与血管内皮功能减低和主动脉顺应性改变关系密切。OBJECTIVE To investigate the correlation between vascular endothelial function and aortic compliance in patients with obstructive sleep apnea hypopnea syndrome（OSAHS） and hypertension. METHODS A total of 103 OSAHS cases were divided into simple OSAHS group（n=55） and OSAHS complicated with hypertension group（n=48, OSAHS＋HT group）. 20 patients with simple hypertension were included into the hypertension group, and 20 healthy people served as controls. Vascular endothelial function was evaluated by detecting flow mediated dilation of the brachial artery（FMD） with color Doppler; the changes of aortic compliance in patients were detected by echocardiography. RESULTS The FMD, aortic tension and aortic distensibility index levels of OSAHS with hypertension group were significantly lower than the normal control group, hypertension group and OSAHS group（P〈0.05）; The aortic stiffness index level of OSAHS hypertension group was significantly higher than the normal group, the high blood pressure group and OSAHS group（P〈0.05）; Analysis of Spearman correlation coefficient of patients in OSAHS with hypertension group found aortic FMD were positively correlated with aortic stiffness index, negatively correlated with aortic tension index and aortic expansion; The aortic FMD, aortic tension, swelling index and aortic stiffness index in OSAHS hypertension group had positive correlation with AHI （P〈0.05）, and negative correlation with LSaO2（P〈0.05）. CONCLUSION OSAHS is associated with vascular endothelial dysfunction and decreased aortic compliance. When combined with hypertension, vascular endothelialfunction and aortic compliance will be significantly affected. The severity of OSAHS was closely related to the decrease of vascular endothelial function and the changes of aorticcompliance.

关 键 词：高血压 睡眠呼吸暂停  阻塞性 内皮  血管 主动脉 顺应性 

分 类 号：R544.1[医药卫生—心血管疾病] R766[医药卫生—内科学]