老年阻塞性睡眠呼吸暂停低通气综合征合并高血压患者血浆内 ET-1及内源性 NO 表达及意义

Expression and Significance of Endothelin-1 and Nitric Oxide in Plasma Samples from Senile Hypertensive Patients with Obstructive Sleep Apnea Hypopnea Syndrome

【目的】探讨老年阻塞性睡眠呼吸暂停低通气综合征（OSAHS）合并高血压患者血浆内皮素（ET‐1）及内源性一氧化氮（NO）的表达及意义。【方法】选取老年OSAHS合并高血压患者60例（A组）、单纯老年OS‐AHS患者60例（B组）及正常健康体检者60例（C组），采用ELISA法测定ET‐1，硝酸还原酶法测定NO ，多导睡眠仪监测睡眠呼吸指标，包括呼吸暂停低通气指数（AHI）、微觉醒指数（MAI）、平均动脉血氧饱和度（MSaO2）、最低动脉血氧饱和度（LSaO2）、呼吸障碍最长时间，分析ET‐1、NO与睡眠呼吸指标的相关性。【结果】A组与B组ET‐1、ET／NO均显著高于C组（ P＜0．05），NO均低于C组；A组ET‐1、ET／NO显著高于B组（ P ＜0．05）， NO低于B组（ P＜0．05）；A组AHI、MAI、呼吸障碍最长时间均显著高于 B组（ P＜0．05），LSaO2、MSaO2指标均低于B组（ P＜0．05）。在A组中，血浆ET‐1水平与AHI呈正相关（ r＝0．526，P＜0．05），与LSaO2、MSaO2呈负相关（ r＝－0．275，r ＝－0．192，P ＜0．05）；血浆NO水平与AHI、MSaO2呈负相关（ r ＝－0．484，r ＝－0．536，P＜0．05），与LSaO2呈正相关（ r＝0．589，P＜0．05）。【结论】老年OSAHS合并高血压患者血浆ET‐1及NO水平异常，内皮功能损伤可能参与了老年 OSAHS合并高血压病变过程。

[Objective] To explore the expression and significance of endothelin‐1 （ET‐1） and endogenous nitric oxide （NO） in senile hypertensive patients with obstructive sleep apnea hypopnea syndrome （OSAHS） .[Methods] A total of 60 senile hypertensive OSAHS patients were recruited from May 2012 to August 2014 . And 60 simple OSAHS elders and 60 healthy subjects were selected as controls .ET‐1 was measured by en‐zyme‐linked immunosorbent assay （ELISA） and NO by nitrate reduction enzymatic method .And such sleep apnea monitoring indicators as apnea‐hypopnea index （AHI） ,arousal index （MAI） ,average oxygen saturation （MSaO2 ） ,lowest oxygen saturation （LSaO2） and longest time of respiratory disorders were determined by polysomnography .The clinical data were recorded and analyzed .[Results] AHI ,MAI and respiratory disor‐der maximum time were significantly higher in OSAHS with hypertension group than those in OSAHS group （ P 〈0 .05） .Both LSaO2 and MSaO2 were lower in OSAHS group than those in control group （ P 〈0 .05） . ET‐1 and ET/NO were significantly higher in OSAHS and OSAHS hypertension groups （ P〈0 .05） ,NO was lower in control group than that in OSAHS group .ET‐1 and ET/NO were significantly higher in OSAHS with hypertension group than those in OSAHS group （ P〈0 .05） .NO was lower in OSAHS group （ P 〈0 .05） . Plasma ET‐1 level and AHI were positively correlated （ r=0 .526 ,P〈0 .05） and LSaO2 and MSaO2 negative‐ly correlated （ r = -0 .275 ,r = -0 .192 ,P〈0 .05） .In hypertensive patients with OSAHS ,the plasma level of NO and AHI had negative correlations with MSaO2 （ r = -0 .484 ,r = -0 .536 ,P 〈0 .05） and a positive correlation with LSaO2 （ r =0 .589 ,P〈0 .05） .[Conclusion] The plasma levels of ET‐1 and NO are abnormal in senile OSAHS patients with hypertension .And endothelial dysfunction may be involved in disease process .