阻塞性呼吸睡眠暂停低通气综合征患者血清血管内皮生长因子的变化及意义

Change and significance of vascular endothelial growth factor in obstructive sleep apnea hypopnea syndrome patients

目的 探讨血清血管内皮生长因子 (vascularendothelialgrowthfactor,VEGF)在阻塞性呼吸睡眠暂停低通气综合征 (obstructivesleepapneahypopneasyndrome,OSAHS)患者及部分患者经鼻持续正压通气 (nasalcontinuouspositiveairpressure ,nCPAP)治疗后的变化及意义。 方法 采用酶联免疫吸附测定法检测经多导睡眠监测仪 (PSG)确诊的 31例OSAHS患者及 30例健康对照血清VEGF水平及部分经nCPAP治疗后的患者血清VEGF水平 ,并监测患者呼吸紊乱指数 (AHI)、血氧饱和度小于 90 %的睡眠时间占总睡眠时间比率 (SIT90 )、平均血氧饱和度 (MSaO2 )、最低血氧饱和度 (LSaO2 )等睡眠指标。结果 OSAHS患者根据AHI分为轻、中、重 3组 ;健康对照组与OSAHS轻度、中度、重度组比较血清VEGF水平差异有统计学意义 (均P <0 .0 1) ;OSAHS患者血清VEGF水平与SIT90 呈正相关 (r=0 .76 8,P <0 .0 1) ,与MSaO2 、LSaO2 呈负相关 (r分别为 - 0 .779、- 0 .774 ,均P <0 .0 1) ;10例OSAHS患者nCPAP治疗半年后血清VEGF水平 (5 2 0 .2 4± 90 .4 5 )ng/L ,治疗前 (70 3.76± 92 .77)ng/L ,治疗前后差异有统计学意义 (P <0 .0 1)。结论 夜间反复低氧血症可使VEGF表达增加 ,血清VEGF水平升高 ,促进血管再生 ,可能对抗OSAHS相关心血管疾病的?

Objective To study the vascular endothelial growth factor(VEGF) levels in the patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and some patients with nasal continuous positive air pressure(nCPAP) treatment for its role in the pathogenesis of coronary artery disease in the OSAHS patients.Methods Thirty-one OSAHS patients were confirmed by polysomnogrophy(PSG),thirty healthy subjects were recruited as the control group.Ten patients with OSAHS were treated by nCPAP,serum VEGF was measured by enzyme-linked immunosorbent assay.Sleeping items such as apnea hypopnea index(AHI),percentage of time spent at SaO 2 below 90% in the total sleep period(SIT 90 ),mean SaO 2(MSaO 2),lowest SaO 2(LSaO 2) and others were observed in the patients.Results OSAHS patients were divided into three groups according to light,medium and serious AHI.Serum VEGF in the above three groups increased more significantly in contrast to that of the healthy control group (All P< 0.01 ).Serum VEGF level correlated positively with SIT 90 level(r= 0.78 ,P< 0.01 ),while negatively with MSaO 2 and LSaO 2 level (r= -0.779 , -0.774 ,P< 0.01 ).After nCPAP treatment in the ten OSAHS patients for half year,serum VEGF decreased to ( 520.24 ± 90.45 ) ng/L,as that before was ( 703.76 ± 92.77 ) ng/L,showing statistic significance(P< 0.01 ).Conclusion Nocturnal recurrent hypoxia results in higher VEGF expression and high serum VEGF level,enhancing vascular regeneration possibly against OSAHS-related vascular diseases.With nCPAP treatment,serum VEGF level decreases,which may be associated with a new fitness of the body.