摘要
目的初步探讨血管内皮生长因子（vascular endothelial growth factor，VEGF）及一氧化氮（nitric oxide，NO）在阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea—hypopnea syndrome，OSAHS）病理生理过程中的意义。方法①20例单纯OSAHS患者、26例OSAHS合并心脑血管病患者和20例正常人，经多导睡眠仪监测后，检测血浆VEGF和NO浓度。②将OSAHS合并心脑血管病患者分成两组，一组给予经鼻持续正压通气（nCPAP）治疗6个月，共15例设为nCPAP治疗组；其余11例不给予任何针对OSAHS的治疗，设为对照组；观察治疗前后的血浆VEGF和NO浓度。结果①三组血浆VEGF浓度从高到低分别为：OSAHS合并心脑血管病患者（194．9±67．9）pg／ml、单纯OSAHS患者（140．6±47．8）pg／ml、正常对照组（115．0±54．1）pg／ml，差异有统计学意义；②三组血浆NO浓度从低到高分别为：OSAHS合并心脑血管病患者（58．7±17．7）μmol／L、单纯OSAHS患者（76．0±23．7）μmol／L、正常对照组（86．3±45．0）μmol／L，差异有统计学意义；③接受nCPAP治疗的OSAHS合并心脑血管病患者6个月后血浆VEGF浓度较治疗前下降[（217．6±53．2）pg／ml vs（136．2±29．9）pg／ml，P〈o．013，血浆NO浓度较治疗前升高[（56．0士16.8）／2mol／L协（80．3±16．7）μmol／L，P〈0．01]。结论①OSAHS患者血浆VEGF浓度升高，血浆NO水平下降；②合并心脑血管病的OSAHS患者比无心脑血管并发症的单纯OSAHS患者血浆VEGF浓度升高更显著，血浆NO水平下降更明显；③经nCPAP治疗后，OSAHS合并心脑血管病患者血浆VEGF浓度下降，血浆NO水平增加。
Objective To investigate the changes of vascular endothelial growth factor（VEGF） and nitric oxide （NO） in obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods All the subjects underwent overnight polysomnography. In Experiment 1 ,plasma concentrations of VEGF were measured by a quantitative enzyme-linked immunoassay technique and plasma levels of NO were measured as plasma nitrites and nitrates in group 10SAHS patients with cardiovascular or cerebrovascular diseases （ n = 26）; group 20SAHS patients without cardiovascular or cerehrovascular diseases （ n = 20） ; group 3 healthy adults（ n = 20）. In Experiment 2, OSAHS patients with cardiovascular or cerebrovascular diseases were divided into two subgroups, which were classified：＂nCPAP acceptors＂ including the patients who accepted nasal continuous positive airway pressure treatment （nCPAP）（ n = 15） and ＂controls＂including patients who did not accept any treatment for OSAHS（n= 11）. VEGF and NO concentrations were compared in each subgroup before and half-year after treatment with nCPAP. Results Experiment 1 ：（1） VEGF concentrations were found to be significantly higher in OSAHS patients compared with healthy adults, with （194.9 ± 67.9） ingroup 1 , （ 140.6 ± 47.8 ） in group 2 and （ 115.0 ± 54.1 ） pg / mlingroup 3 , respectively （ P 〈 0.01 ）.（2） Plasma NO levels were lower in OSAHS patients than healthy adults,with （58.7± 17.7） in group 1, （76.0±23.7） in group 2 and （86.3±45.0） μmol/L in group 3, respectively（ P 〈0.05）. Moreover,OSAHS with cardiovascular or cerebrovascular diseases had higher VEGF levels and lower NO levels than those without cardiovascular or cerebrovascular diseases. Experiment 2： A significant decrease in VEGF concentrations and a significant increase in NO levels were found in＂nCPAP acceptors＂after treatment [（217.6±53.2） pg/ml vs （136.2±29.9） pg/ml, P 〈0.01];[（56.0±16.8） μmol/L vs （80.3±16.7） μmol/L, P 〈0.01]. Th
出处
《国际呼吸杂志》
2007年第17期1281-1284,共4页
International Journal of Respiration
