睡眠呼吸暂停综合征对部分心血管活性物质变化的影响

Effect of sleep apnea syndrome on some active cardiovascular substances

目的:观察不同程度睡眠呼吸暂停(SAS)患者部分血管活性物质如内皮素-1(ET-1)、血管紧张素II(AngII)、血栓烷素B2(TXB2)、6-酮-前列腺素F1α(6-keto-PGF1α)、降钙素基因相关肽(CGRP)的变化及其相关性,旨在深入了解SAS引起心血管病的机制,为有效防治SAS患者的心血管并发病提供实验依据。方法:疑似SAS患者共37例,男32例,女5例,平均(55. 70±10. 66)岁,进行多导睡眠呼吸监测,记录呼吸暂停指数(AI)、呼吸紊乱指数(RDI)。根据RDI分为正常组,轻度SAS组,中度SAS和重度SAS组。监测前抽血,用放免法测定ET-1、AngII、TXB2、6-keto-PGF1α、CGRP。结果:①中、重度SAS组ET-1、AngII、TXB2水平显著高于正常组,但四组6-keto-PGF1α、CGRP水平均无统计学差异;②相关分析结果显示:AI、RDI与ET-1、AngII、TXB2水平显著正相关, 6-keto-PGF1α、CGRP水平则与SAS参数无显著相关性。结论:部分血管活性物质如ET-1, AngII和TXB2在SAS引起的心血管疾病发生发展中发挥重要作用。

Objective:we investigated the change of some active vascular substances such as endothelium(ET)-1, angiotensin II(AngII),Thromboxane B2 (TXB 2), 6-keto-prostagladin (PGF)1α, calcium gene related protein(CGRP) in various severity of sleep apnea syndrome(SAS) and their relativity in order to futher understand the mechanism of how sleep apnea syndrome causes cardiovascular diseases and provide experimental evidences for the effective prevention and treatment of cardiovascular diseases in patients with SAS. Methods:37 patients primarily diagonesed as SAS, 32 men and 5 women, mean age(55.70±10.66) years old. They underwent polysomnography(PSG) test, apnea index(AI) and respiratory disorder index(RDI) were recorded. The patients were divided into normal, mild, medium and severe SAS group according to RDI. The blood ET-1, AngII, TXB 2,6-keto-PGF1α, CGRP were examined by means of radioimmune assay. Results:1. The blood ET-1, AngII and TXB 2 level was significantly higher in medium and severe SAS groups than that in normal and mild SAS groups, but there were no differences of blood 6-keto-PGF1α and CGRP level among all four groups. 2. correlation analysis showed that AI and RDI were significantly and positively correlated to ET-1, AngII and TXB 2 level, but had no correlation with 6-keto-PGF1α and CGRP level. Conclusion:some vascular substances such as ET-1, AngII and TXB 2 play an important role in the pathogenesis of cardiovascular diseases complicated with SAS.