CPAP对高原地区OSAHS患者氧化应激的干预作用

Intervention effect of continuous positive airway pressure ventilation on oxidative stress in patients with obstructive sleep apnea hypopnea syndrome

目的探讨持续气道正压(CPAP)通气对高原阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者氧化应激的干预作用。方法对42例高原OSAHS患者监测了AHI、MSaO2、T80。在睡前、晨起及CPAP治疗6周晨起分别测血清8-iso-PGF2α、SOD、MDA、T-AOC,并与30例健康组比较。结果 OSAHS组睡前血清8-isoPGF2α、MDA显著高于,SOD、T-AOC显著低于健康组(均P<0.01);OSAHS组晨起血清8-isoPGF2α、MDA显著高于,SOD、T-AOC显著低于睡前(均P<0.01);治疗前,AHI、T80与晨起血清8-isoPGF2α、MDA显著正相关,与血清SOD、T-AOC显著负相关(均P<0.01);MSaO2与8-isoPGF2α、MDA显著负相关,与SOD、T-AOC显著正相关(均P<0.01)。OSAHS组治疗后晨起与治疗前晨起比较,血清8-isoPGF2α、MDA显著降低,SOD、T-AOC显著升高(均P<0.01)。结论高原OSAHS患者存在持续性氧化应激,晨起较睡前严重,且与病情程度有显著相关性。CPAP通气治疗能有效地改善OSAHS患者氧化应激。

Objective To investigate the intervention effect of continuous positive airway pressure （CPAP） ventilation on oxidative stress in patients with obstructive sleep apnea hypopnea syndrome （OSAHS） at high altitude. Methods AH1, MSO2 and T50 were detected in 42 patients with OSAHS. The levels of 8-iso-PGF2α, SOD, MDA and T-AOC were measured before bedtime and in the morn- ing. The results were compared with 30 healthy volunteers as the control group. Results The levels of serum 8-iso-PGF20, and MDA increased more obviously, and the levels of SOD and T-AOC decreased more clearly in the observation group than in the control group before bedtime （P 〈 0. 01 ）. Before the treatment, the levels of AHI and T80 were positively related with the levels of serum 8-iso-PGF2α, and MDA, and negatively related with SOD and T-AOC （P 〈0. 01 ）. The levels of 8-iso-PGF2α and MD decreased obviously, and the levels of SOD and T-AOC increased obviously in the morning 6 weeks after the treatment （P 〈 0.01 ）. Conclusion There exists oxidative stress in patients with OSAHS at high altitude, which is more severe in the morning than bedtime. It is correlated with disease severity. CPAP treatment can effectively improve their oxidative stress in patients with OSAHS.