下颌前移矫治器对OSAHS患者血浆ET-1、AngⅡ水平和血压的影响  

Effects of mandibular advancement device on plasma levels of ET-1,Ang II and blood pressure in patients with OSAHS

作　　者：张士珑 乔星 康文静 刘春艳 刘晔 杨秀春[2] 卢海燕 ZHANG Shi-long;QIAO Xing;KANG Wen-jing;LIU Chun-yan;LIU Ye;YANG Xiu-chun;LU Hai-yan(Department of Orthodontics,Hebei Key Laboratory of Stomatology,Hebei Clinical Research Center for Oral Diseases,School and Hospital of Stomatology,Hebei Medical University,Shijiazhuang 050017,China)

机构地区：[1]河北医科大学口腔医学院口腔医院正畸科、河北省口腔医学重点实验室、河北省口腔疾病临床医学研究中心,石家庄050017 [2]河北医科大学第二医院心血管内科

出　　处：《北京口腔医学》2022年第5期340-345,共6页Beijing Journal of Stomatology

基　　金：河北省医学科学研究课题(20210144);河北省自然科学基金(H2020206465);河北省重点研发计划项目(202130807020019)。

摘　　要：目的研究下颌前移矫治器(mandibular advancement device,MAD)治疗阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)对患者血浆血管内皮素-1(endothelin-1,ET-1)、血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)和血压的影响。方法选取中重度OSAHS合并一级高血压患者20例,其中男性19例、女性1例,平均年龄为(54±12)岁,使用下颌前移矫治器治疗半年。治疗前后分别进行上气道测量、Epworth评估、多导睡眠监测(polysomnography,PSG)和血压测量,放射免疫法测定血浆中ET-1、AngⅡ含量。结果血浆ET-1、AngⅡ含量治疗后分别为(57.76±9.36)pk/ml、(85.29±13.52)pk/ml,较治疗前的(63.90±11.07)pk/ml、(94.26±16.38)pk/ml显著降低(P<0.05);收缩压治疗后为(120±8.95)mmHg,较治疗前的(135.25±15.98)mmHg显著下降(P<0.05);舒张压治疗后为(92.48±10.37)mmHg,与治疗前的(95.53±12.36)mmHg相比无差异(P>0.05)。结论MAD治疗OSAHS患者可以降低血浆中ET-1和AngⅡ水平,改善血压。Objective To study the effects of MAD on plasmatic levels of ET-1 and AngⅡand blood pressure of patients with OSAHS.Methods Twenty patients with moderate and severe OSAHS and primary hypertension were selected and treated with MAD for half a year.Upper airway measurements,polysomnography,Epworth evaluation and blood pressure measurements were performed before and after treatment,and levels of ET-1 and AngⅡin plasma were measured by radioimmunoassay.Results The levels of ET-1 and Ang II in plasma were(57.76±9.36)pk/ml and(85.29±13.52)pk/ml respectively after treatment,which were significantly lower than those before treatment(63.90±11.07)pk/ml and(94.26±16.38)pk/ml,(P<0.05).The systolic pressure was 120±8.95mmHg after treatment,which was significantly lower than(135.25±15.98)mmHg before treatment(P<0.05).The diastolic blood pressure was(92.48±10.37)mmHg after treatment,and there was no difference compared with(95.53±12.36)mmHg before treatment(P>0.05).Conclusions Treating OSAHS patients with MAD can reduce plasmatic levels of ET-1 and AngⅡand improve blood pressure.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 下颌前移矫治器 ET-1 AngⅡ 血压 

分 类 号：R766[医药卫生—耳鼻咽喉科]