阻塞性睡眠呼吸暂停低通气综合征合并高血压患者内皮功能标志物检测的临床意义

Clinical significance of endothelial function markers detection in OSAHS patients combined with hypertension

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压患者血清一氧化氮(NO)、血浆内皮素-1(ET-1)及内皮微粒(EMP)的水平变化及其相关性,为OSAHS合并高血压的早期预防和治疗提供依据。方法选择2016年1月至12月在吉林大学第一医院就诊的OSAHS患者80例:单纯OSAHS患者(单纯OSAHS组)40例,其中男性32例,女性8例,年龄(54.5±7.8)岁;合并高血压患者(合并高血压组)40例,其中男性33例,女性7例,年龄(54.2±7.3)岁。对照组为30例健康体检者,其中男性24例,女性6例,年龄(54.2±7.5)岁。分别采用比色法检测NO,双抗体夹心法检测ET-1,流式细胞技术检测EMP。结果合并高血压组、单纯OSAHS组ET-1、EMP水平均显著高于对照组(P<0.01),NO低于对照组(P<0.01);对照组、单纯OSAHS组、合并高血压组ET-1水平依次升高(F=19.661,P<0.01),EMP水平亦依次升高(F=606.748,P<0.01),NO依次降低(F=61.601,P<0.01);合并高血压组EMP与ET-1正相关(r=0.841,P<0.05),与NO负相关(r=-0.944,P<0.05);单纯OSAHS组EMP与ET-1正相关(r=0.780,P<0.05),与NO负相关(r=-0.897,P<0.05)。结论 OSAHS患者合并高血压与ET-1、EMP、NO水平有关,联合监测上述指标早期改善OSAHS患者通气功能,能够评估OSAHS并发高血压的发生,为临床治疗提供参考。

Objective To study the correlation changes of serum nitric oxide（NO）, plasma endothelin-1（ET-1） and endothelial micro-particles（EMP） in obstructive sleep apnea hypopnea syndrome（OSAHS） patients combined with hypertension（HT） and provide basis for early prevention and treatment. Methods From January to December 2016, 80 cases of OSAHS were divided into OSAHS group[n = 40, included 32 males and 8 females, aged（54.5 ± 7.8） years old] and OSAHS combined with HT group[n = 40, included 33 males and 7 females, aged（54.2 ± 7.3） years old]. Thirty healthy subjects were recruited as control group,included 24 males and 6 females, aged（54.2 ± 7.5） years old. The NO was determined by colorimetric method, ET-1 by double antibody sandwich method and EMP by flow cytometry, respectively. Results The level of ET-1 and EMP in OSAHS combined with HT group and OSAHS group were significantly higher than those in control group（ P〈0.01）, while the NO level were lower than that in control group（P〈0.01）. The ET-1 level in control group, OSAHS group and OSAHS combined with HT group were successively increased（F = 19.661, P〈0.01）, as well as the EMP level（F = 606.748, P〈0.01）, while NO level successively decreased（F = 61.601, P〈0.01）. In OSAHS combined with HT group, EMP was positively correlated with ET-1（r = 0.841, P〈0.05）, but negatively correlated with NO（r =-0.944, P〈0.05）. In OSAHS group, EMP was positively correlated with ET-1（r = 0.780, P〈0.05）, but negatively correlated with NO（r =-0.897, P〈0.05）. Conclusion It is demonstrated that ET-1, EMP and NO level are related to the symptom of OSAHS patients combined with hypertension. Early com-bined detection of the markers can estimate the improvement of ventilation function in OSAHS patients, which provide the ref-erences for clinical treatment.