摘要
目的探讨经鼻持续气道正压通气(n-CPAP)对阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)伴高血压患者氧化应激反应、血管内皮功能及血压的影响。方法根据OSAHS及高血压诊断标准将研究对象分为OSAHS伴高血压组(35例)、OSAHS组(32例)、高血压组(31例)及健康对照组(34例)。测定患者24小时动态血压,采用酶联免疫吸附测定(ELISA)检测患者血清中人内皮素-1(ET-1)、内皮型一氧化氮合酶(e NOS)、血管内皮细胞生长因子(VEGF)及8-羟基脱氧鸟苷(8-OHd G)水平。结果 n-CPAP治疗7天后,10例重度OSAHS伴高血压患者血清8-OHd G、ET-1及VEGF水平均显著下降(P<0.01),而血清e NOS水平显著升高(P<0.01),24小时平均收缩压和平均舒张压均得到显著改善(P<0.01);OSAHS伴高血压组患者血清8-OHd G、ET-1及VEGF水平均明显高于OSAHS组、高血压组及健康对照组(P<0.01),而血清e NOS水平低于OSAHS组、高血压组及健康对照组(P<0.01或0.05);OSAHS组患者血清8-OHd G和ET-1水平均明显高于健康对照组(P<0.01),血清8-OHd G水平明显高于高血压组(P<0.01),而血清e NOS水平明显低于高血压组和健康对照组(P<0.01);高血压组患者血清ET-1水平明显高于健康对照组(P<0.01)。结论血清8-OHG、ET-1及VEGF水平在OSAHS伴高血压患者体内升高,而e NOS水平降低,提示患者体内存在氧化应激及血管内皮功能障碍。n-CPAP可通过抑制氧化应激改善血管内皮功能,是OSAHS伴高血压患者的有效降压措施。
ObjectiveTo investigate the effect of n-CPAP on oxidative stress, vascular endothelial function and blood pressure in obstructive sleep apnea-hypopnea syndrome (OSAHS) combined with hypertension patients. MethodAccording to OSAHS and the diagnostic criteria of hypertension, the research objects were divided into OSAHS combined with hypertension group (35 cases), OSAHS group (32 cases), Hypertension group (31 cases), and healthy control group (34 cases). The 24 hours dynamic blood pressure was measured, and the levels of 8-OHdG, VEGF, eNOS and ET-1 were measured by ELISA.Result7 days after treatment with n-CPAP, serum 8-OHdG, ET-1 and VEGF levels of 10 patients with severe OSAHS combined with hypertension were signiifcantly decreased (P〈0.01), and serum eNOS levels increased signiifcantly (P〈0.01); 24 hours mean SBP and mean DBP were signiifcantly improved (P〈0.01); serum 8-OHdG, ET-1 and VEGF levels of OSAHS combined with hypertension group were signiifcantly higher than OSAHS group, hypertension group and healthy control group (P〈0.01), and serum eNOS level was lower than OSAHS group, hypertension group and healthy control group (P〈0.01 or 0.05); 8-OHdG and ET-1 serum levels of OSAHS group were signiifcantly higher than healthy control group (P〈0.01), serum 8-OHdG level was signiifcantly higher than hypertension group (P〈0.01), and serum eNOS level was signiifcantly lower than hypertension group and healthy control group (P〈0.01); serum ET-1 level of hypertension group was signiifcantly higher than healthy control group (P〈0.01).Conclusion Serum 8-OHG, ET-1 and VEGF levels rise in OSAHS combined with hypertension patients, while eNOS level declines, which indicated oxidative stress and endothelial dysfunction are present in patients. n-CPAP can improve the vascular endothelial function of OSAHS combined with hypertension patients by inhibiting oxidative stress, and it is effective for OSAHS combined with hypertension patients to reduce blo
出处
《中国医学前沿杂志(电子版)》
2015年第9期60-63,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
经鼻持续气道正压通气
阻塞性睡眠呼吸暂停低通气综合征
高血压
氧化应激
血管内皮功能
Nasal continuous positive airway pressure
Obstructive sleep apnea-hypopnea syndrome
Hypertension
Oxidative stress
Vascular endothelial function