重度阻塞性睡眠呼吸暂停低通气综合征患者血浆一氧化氮与内皮素-1水平测定的意义

发布时间：2018-03-25 19:09

本文选题：睡眠呼吸暂停低通气综合征　切入点：阻塞性　出处：《武汉大学学报(医学版)》2014年04期

【摘要】：目的:探讨重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆一氧化氮(NO)与内皮素-1(ET-1)水平以及手术治疗对NO和ET-1水平的影响。方法:经睡眠呼吸监测(PSG)检查确诊为重度OSAHS患者29例,依据是否伴有高血压分为A组(合并有高血压)和B组(无高血压),均行多平面分期手术,另选择30例年龄、性别、体重指数(BMI)等均相匹配的健康者作为对照组(C组)。采用固相夹心法酶联免疫吸附实验测定OSAHS患者术前、术后6个月血浆NO和ET-1水平,分析其与呼吸暂停低通气指数(AHI)及最低血氧饱和度(LSaO2)的相关性及术前、术后血浆NO和ET-1水平的变化。结果:A、B组血浆ET-1和ET-1/NO比值水平显著高于C组(P0.05),且与AHI呈正相关(r=0.658,P0.05),与LSaO2呈负相关(r=-0.543,P0.05);NO显著低于对照组(P0.05),29例OSAHS患者术后6个月血浆ET-1和ET-1/NO比值水平明显低于术前(P0.05),而NO显著高于术前,且这种差异与BMI无关。结论:OSAHS患者存在血管内皮损伤,其中内皮功能失调在OSAHS合并高血压患者中更为明显;OSAHS患者血浆ET-1水平升高和NO水平下降,其原因可能与夜间反复多次发作呼吸暂停及低氧血症有关,有效的外科手术治疗可使血浆ET-1水平下降和NO水平升高。
[Abstract]:Objective: to investigate the plasma levels of nitric oxide (no) and endothelin-1 (ET-1) in patients with severe obstructive sleep apnea hypopnea syndrome (OSAHS) and the effects of surgical treatment on the levels of no and ET-1. There were 29 patients with severe OSAHS. Patients with hypertension were divided into two groups: group A (complicated with hypertension) and group B (without hypertension). The plasma levels of no and ET-1 in OSAHS patients were measured by solid phase sandwich enzyme-linked immunosorbent assay (Elisa) before and 6 months after operation. To analyze its correlation with apnea hypopnea index (AHII) and minimum oxygen saturation (LSaO2) and preoperative analysis. Results the ratio of plasma ET-1 and ET-1/NO in group B was significantly higher than that in group C (P 0.05), and had a positive correlation with AHI (P 0.05), and negatively correlated with LSaO2 (P 0.05). The level of no was significantly lower than that of control group (P 0.0530) at 6 months after OSAHS operation. The ratio level was significantly lower than that before operation (P 0.05), but no was significantly higher than that before operation. Conclusion there is vascular endothelial injury in patients with BMI, and endothelial dysfunction is more obvious in patients with OSAHS complicated with hypertension than in patients with OSAHS. The causes may be related to repeated nocturnal apnea and hypoxemia. Effective surgical treatment can decrease plasma ET-1 level and increase no level.
【作者单位】：贵州省人民医院耳鼻咽喉头颈外科;贵州省人民医院检验科;遵义医学院第三附属医院耳鼻咽喉科;
【基金】：贵州省科技厅社会发展攻关项目(黔科合:SY[2010]3134)
【分类号】：R766

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