阻塞性睡眠呼吸暂停低通气综合征合并高血压患者血内皮素、一氧化氮及肿瘤坏死因子-α水平的变化

The changes of ET,NO and TNF-α levels of blood in OSAHS patients OSAHS and OSAHS patients with hypertension

目的探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)及阻塞性睡眠呼吸暂停低通气综合征合并高血压患者血管内皮功能的变化。方法检测OSAHS、OSAHS合并高血压患者血ET、NO、TNF-α含量并与睡眠呼吸监测指标进行相关性分析。结果单纯OSAHS、OSAHS合并高血压患者与对照组比较,ET、TNF-α及ET/NO比值升高,NO降低,并与两者病情严重程度有相关性;ET及ET/NO比值的升高在OSAHS合并高血压患者组更明显。结论OSAHS患者及OSAHS合并高血压患者均存在血管内皮损伤,内皮功能失调在OSAHS合并高血压患者中更为明显。OSAHS患者的血管内皮损伤、内皮功能障碍是独立于或先于高血压的发生而发展的。

Objective To explore the changes of vascular endothelial function in patients with obstructive sleep apnea-hypopnea syndrome （OSAHS）and obsturctive sleep apnea-hypopnea associated hypertension （OSAHAHT）. Methods ET, NO and TNF-α concentrations in blood of patients with OSAHS without complications and patients with OSAHAHT were measured. Furthermore, linear correlations were performed between three biochemical parameters and sleep-breathing parameters of patients with OSAHS and OSAHAHT,respectively. Results Compared with control subjects,ET and TNF-α concentrations were higher, NO concentration was lower and ET/NO ratio was higher in patients with OSAHS and OSAHAHT. There have significant correlations between the change of blood parameters and the severity of desease. The changes of ET and ET/NO were more obvious in patients with OSAHAHT. Conclusions The endothelial damage exists in OSAHS patients no matter with or without hypertension. The endothelial dysfunction was more obvious in patients with OSAHAHT. The endothelial damage and dysfunction of OSAHS occur independent of, and possibly prior to,the development of systemic hypertension.