睡眠呼吸暂停低通气综合征患者血管活性物质的变化

Effect of sleep-apnea syndrome on vasoactive substances

目的 观察不同程度睡眠呼吸暂停低通气综合征(SAHS)患者血管活性物质内皮素-1(ET-1)、血管紧张素Ⅱ(AngⅡ)、血栓烷素B2(TXB_2)、6-酮-前列腺素F_(1α)(6-keto-PGF_(1α))、降钙素基因相关肽(CGRP)的变化及其相关性，旨在深入了解SAHS引起心血管病的机制，为有效防治SAHS患者的心血管并发病提供实验依据。资料与方法 疑似SAHS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，记录呼吸暂停低通气指数(AHI)、呼吸紊乱指数(RDI)。根据RDI分为正常组，轻度SAHS组，中度SAHS和重度SAHS组。睡眠呼吸监测结束后即刻抽血，用放免法测定ET-1、AngⅡ、TXB_2、6-keto-PGF_(1α)、CGRP。结果 ①重度SAHS组的BMI显著大于正常及轻、中度组；②中、重度SAHS组ET-Ⅰ、AngⅡ、TXB_2水平显著高于正常组及轻、中度组，但四组6-keto-PGF_(1α)、CGRP水平均无统计学差异；③相关分析结果显示：AHI、RDI与ET-Ⅰ、AngⅡ、TXB_2水平显著正相关，6-keto-PGF_(1α)、CGRP水平则与SAHS参数无显著相关性。结论 体重指数与SAHS的发生发展密切相关，部分心血管活性物质如FF-Ⅰ，AngⅡ和TXB_2在SAHS引起的心血管疾病发生发展中发挥重要作用。

Objective To investigate the changes of vasoactive substances such as endothelium（ET）-1, angiotensin Ⅱ（Ang Ⅱ）, thromboxane B2 （TXB2）, 6-keto-prostaglandin （PGF）1α, calcium gene related protein（CGRP） levels in patients with sleep apnea-hypopnea syndrome（SAHS） and their relation to the severity of respiratory disorder index （RDI）. Methods Thirty-seven patients with suspected SAILS, 32 men and 5 women, mean age （55.70±10.66） years old, underwent polysomnography（PSG） test. Apnea-hypopnea index（AHI） and RDI were recorded. The patients were divided into normal, mild, medium and severe SAHS groups according to RDI. Plasma levels of ET-1, Ang Ⅱ, TXB2,6-keto-PGF1α, CGRP were examined by radioimmunoassay. Resuits 1. BMI of severe SAHS group was significantly higher than that of normal, mild and medium SAHS groups. 2. Blood ET-1, Ang Ⅱ and TXB2 levels were significantly higher in medium and severe SAHS groups than those in normal and mild SAHS groups, but there were no differences in blood 6-keto-PGF1α and CGRP levels among all four groups. 3. Correlation analysis showed that AHI and RDI were significantly positively correlated to ET-1, Ang Ⅱ and TXB2 levels, but had no eorrelatiou with 6-keto-PGF1α and CGRP level. Conclusions BMI is significantly related to the occurrence and development of SAHS. Vasoactive substances such as ET-1, Ang H and TXB2 might play important role in the pathogenesis of cardiovascular diseases complicated by SAHS.