手术治疗对阻塞性睡眠呼吸暂停低通气综合征肺动脉压力和肾上腺髓质素的影响

The influences of surgical treatment on pulmonary artery pressure and adrenomedullin in OSAHS patients

目的观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)病人解除上呼吸道梗阻的手术治疗对肺动脉压力(pulmonary artery pressure,PAP)和血肾上腺髓质素(adrenomedullin,ADM)的变化的影响。方法39例OSAHS病人,手术治疗前1天和术后第7天,分别用彩色多普勒诊断分析仪测定PAP和放射免疫分析法测定血液ADM的水平。结果术前1天PAP的均值为(64.31±11.72)mmHg,术后第7天为(29.27±16.65)mmHg,手术治疗后PAP明显降低(P<0.01);术前1天血ADM为(89.47±19.18)pg/ml,术后第7天为(48.92±23.17)pg/ml,手术后病人血ADM水平明显下降(P<0.01)。结论手术解除上呼吸道梗阻能明显降低肺动脉压力和血液ADM水平,ADM可能参与了OSAHS的肺动脉高压的病理生理过程。

Objective To obese the influences of operations relieving the obstruction of the upper respiratory tract on pulmonary artery pressure （PAP） and blood adrenomedullin （ADM） in patients with obstructive sleep apnea-hypopnea syndrome （OSAFIS）. Methods PAP was measured by color Doppler echocardiography and blood ADM was detected by mdioimmunoassay technique at one day before operation and the 7th day post-operation, respectively. Results The mean PAP values one day before operation and the 7th day post-operation were （64.31 ± 11.72） mmHg and （29, 27 ± 16.65） mmHg respectively, and those of blood ADM were （89.47 ± 19.18） pg/ml and （48. 92 ± 23. 17） pg/ml. The levels of PAP and blood ADM decreased obviously after operation （ P 〈 0. 01）. Conclusion The operations relieving the obstruction of upper respiratory tract can obviously depress PAP and blood ADM and ADM may play a role in the pathophysiologucal genesis of pulmonary artery hypertension in OSAHS patients.