阻塞性睡眠呼吸暂停低通气综合征合并高血压患者一氧化氮、内皮素1、同型半胱氨酸及C反应蛋白水平的变化及与多导睡眠仪监测指标的关系  

Changes of nitric oxide,endothelin-1,homocysteine and C-reactive protein levels in patients with obstructive sleep apnea hypopnea syndrome complicated with hypertension and their relationship with polysomnography monitoring indexes

作　　者：田剑[1] 刘运秋[2] 兰璇[2] 唐晓霞[2] 王丽晔[2] Tian Jian;Liu Yunqiu;Lan Xuan;Tang Xiaoxia;Wang Liye(Department of Respiratory Medicine,Linxi Hospital,Kailuan General Hospital,Tangshan 063103,China;Department of Respiratory Medicine,Kailuan General Hospital,Tangshan 063000,China)

机构地区：[1]开滦总医院林西医院呼吸内科,河北省唐山市063103 [2]开滦总医院呼吸内科,河北省唐山市063000

出　　处：《中国综合临床》2020年第4期314-318,共5页Clinical Medicine of China

基　　金：中国煤炭工业协会科学技术研究指导性计划项目(MTKJ2014-298)。

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)合并高血压患者一氧化氮、内皮素1、同型半胱氨酸(homocysteine,Hcy)、C反应蛋白(C-reactive protein,CRP)水平的变化及与多导睡眠仪监测指标的关系。方法采用回顾性病例对照研究分析2016年3月至2018年3月开滦总医院及开滦总医院林西医院收治的115例OSAHS合并高血压患者,110例单纯OSAHS患者和同期136名健康体检者的临床资料。比较3组观察对象睡眠相关指标和血清学指标的关系。结果对照组、单纯OSAHS组、OSAHS合并高血压组呼吸暂停低通气指数(apnea hypopnea index,AHI)分别为(2.4±0.8)、(35.7±12.1)、(46.8±13.9)次/h,最低血氧饱和度(lowest oxygen saturation,LSaO2)分别为(87.1±6.8)%、(77.8±6.5)%、(66.9±5.1)%,平均血氧饱和度(mean oxygen saturation,MSpO2)分别为(92.7±6.9)%,(80.9±6.7)%,(71.4±6.3)%,睡眠最长呼吸暂停时间(longest apnea time,LAT)分别为(4.5±0.7)、(48.6±11.3)、(58.2±10.4)s,3组间比较,差异均有统计学意义(F值分别为637.92、329.49、322.96、1420.03,P均<0.05)。对照组、单纯OSAHS组、OSAHS合并高血压组一氧化氮水平分别为(72.8±8.8)、(53.7±7.4)、(42.6±5.9)μmol/L,内皮素1分别为(31.1±6.5)、(45.4±6.7)、(56.6±7.8)ng/L,Hcy分别为(8.7±1.9)、(15.9±6.7)、(31.4±6.3)μmol/L、CRP分别为(1.8±0.6)、(18.6±4.3)、(25.2±6.4)mg/L,3组间比较,差异均有统计学意义(F值分别为517.46、419.02、594.40、982.14,P均<0.05)。Pearson相关性分析结果显示,OSAHS合并高血压患者的内皮素1,Hcy和CRP与AHI和LAT呈正相关(r值分别为0.525、0.704、0.578、0.434、0.464、0.449,P均<0.05),与LSaO2和MSpO2呈负相关(r值分别为-0.477、-0.458、-0.429、-0.517、-0.534、-0.617,P均<0.05)。结论OSAHS合并高血压患者一氧化氮减少,内皮素1、Hcy、CRP升高,且多导睡眠仪监测指标与内皮素1,Hcy,CRP密切相关。Objective To investigate the changes of nitric oxide,endothelin-1(ET-1),homocysteine(Hcy),C-reactive protein(CRP)levels in patients with obstructive sleep apnea hypopnea syndrome(OSAHS)combined with hypertension and the relationship between the changes and polysomnography monitoring indicators.Methods A retrospective case-control study was conducted to analyze the clinical data of 115 patients with OSAHS complicated with hypertension,110 patients with simple OSAHS and 136 healthy persons in Kailuan general hospital and Linxi Hospital of Kailuan general hospital from March 2016 to March 2018.The relationship between sleep related indexes and serological indexes was compared among the three groups.Results In the control group,simple OSAHS group,OSAHS with hypertension group,the apnea hypopnea index(AHI)was(2.4±0.8),(35.7±12.1),(46.8±13.9)times/h,the lowest oxygen saturation(LSaO2)was(87.1±6.8)%,(77.8±6.5)%,(66.9±5.1)%,and the mean oxygen saturation(MSpO2)was(92.7±6.9)%,(80.9±6.7)%,(71.4±6.3)%,and the longest apnea time(LAT)was(4.5±0.7),(48.6±11.3),(58.2±10.4)s.The difference between the three groups was statistically significant(F values were 637.92,329.49,322.96,1420.03,respectively,all P<0.05).Nitric oxide in control group,simple OSAHS group and OSAHS combined with hypertension group were(72.8±8.8),(53.7±7.4),(42.6±5.9)μmol/L.Endothelin-1 was(31.1±6.5),(45.4±6.7),(56.6±7.8)ng/L.Hcy was(8.7±1.9),(15.9±6.7),(31.4±6.3)μmol/L.CRP was(1.8±0.6),(18.6±4.3),(25.2±6.4)mg/L.The difference between the three groups was statistically significant(F valves were 517.46,419.02,594.40,982.14,respectively,all P<0.05).Pearson correlation analysis showed that the levels of endothelin 1,Hcy and CRP in OSAHS patients with hypertension were positively correlated with AHI and LAT(r values were 0.525,0.704,0.578,0.434,0.464 and 0.449,respectively;all P<0.05),and negatively correlated with LSaO2 and MSpO2(r values were-0.477,-0.458,-0.429,-0.517,-0.534 and-0.617,respectively;all P<0.05).Conclusion In OSAHS patient

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 高血压 一氧化氮 内皮素1 同型半胱氨酸 C反应蛋白 

分 类 号：R766[医药卫生—耳鼻咽喉科] R544.1[医药卫生—临床医学]