阻塞性睡眠呼吸暂停低通气综合征患者的血管内皮舒张功能

Endothelium-dependent vasodilation in patients with obstructive sleep apnea-hypopnea syndrome

目的评价阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的血管内皮功能。方法OSAHS患者30例(轻度组8例,中重度组22例)及对照组10例,分别用高分辨率超声检测基础状态、反应性充血时(内皮依赖性血管扩张)以及含服硝酸甘油后(非内皮依赖性血管扩张)的肱动脉内径,计算不同状态下肱动脉的扩张率以评估血管内皮功能。结果对照组、轻度和中重度OSAHS组患者反应性充血时肱动脉内径扩张率分别为(15.2±2.6)%、(14.3±3.2)%和(9.8±4.9)%,中重度OSAHS组患者血管内皮介导的舒张反应较对照组和轻度OSAHS组明显降低;含服硝酸甘油后肱动脉内径扩张率分别为(16.5±5.0)%、(15.7±4.1)%和(14.1±6.2)%,3组间无明显差别。结论中重度OSAHS患者存在血管内皮功能障碍,OSAHS本身可能是导致血管内皮损伤的重要因素。

Objective To evaluate the endothelial function in patients with obstructive sleep apneahypopnea syndrome （OSAHS） by measuring the brachial artery diameter during reactive hyperemia. Methods Thirty patients with OSAHS （8 with mild and 22 with moderate/severe OSAHS） and 10 control subjects were studied. Brachial artery diameter was measured with Doppler ultrasound under baseline conditions, during reactive hyperemia （an endothelium-dependent dilatation ） and after sublingual administration of nitroglycerin （ an endothelium- independent vasodilator）. The dilative rate of brachial artery in different conditions was calculated to evaluate the endothelial function. Results The dilative rate of brachial artery in the control group, the mild OSAHS group and the moderate/severe OSAHS group were （ 15. 2 ±2. 6） % , （ 14. 3 ± 3. 2） % and （9.8 ± 4. 9） % , respectively. There was a significant decrease of endothelium-dependent flow-mediated dilation in the moderate/severe OSAHS group compared to the control group and the mild OSAHS group. No significant difference in endothelium- independent vasodilator after sublingual administration of nitroglycerin was found among the three groups. Conclusion Patients with moderate/severe OSAHS have impaired endothelium-dependent vasodilatation, and OSAHS itself maybe a risk factor for endothelial dysfunction.