阻塞性睡眠呼吸暂停综合征患者抵抗素水平与血管内皮功能相关性以及干预治疗的研究

Association between resistin levels and vascular endothelia function in patients with obstructive sleep apnea syndrome

目的 探讨阻塞性睡眠呼吸暂停综合征 （OSAS）患者血清抵抗素水平与血管内皮功能的关系。方法 选取在南京医科大学附属江宁医院呼吸内科就诊的 OSAS患者45例,分为轻度组15例、中度组15例、重度组15例,另选对照组15例。对其中 OSAS组中30例中、重度患者进行CPAP治疗,并检测治疗前后血清抵抗素水平以及血管内皮功能相关指标 [内皮素-1、NO、抗凝血酶Ⅲ （AT-Ⅲ）]。结果 OSAS组的血清抵抗素水平明显高于对照组,且OSAS各组间有明显差异。血清抵抗素水平与内皮素-1、AT-Ⅲ呈正相关 （P ＆lt;0 05）,与 NO呈负相关 （P ＆lt;0 05）。CPAP治疗后OSAS患者血清抵抗素水平、内皮素-1以及AT-Ⅲ均有下降,而NO则有所上升。结论 OSAS患者血管内皮功能受损与抵抗素水平增高显著相关,抵抗素水平升高与 OSAS严重程度相关。因此,降低血清抵抗素水平有可能成为OSAS合并心脑血管疾病防治的另一种有效方法。

Objective To investigate the association hetween resistin levels and vascular endothelial function in patients with obstructive sleep apnea syndrome （OSAS）. Methods Based on apnea hypopnea index during sleep monitored by polysomnography, 45 patients with OSAS were recruited and divided into a mild OSAS group （ n=15）, a moderate group （ n=15） and a severe group （ n = 15）. Fifteen health subjects were selected as the control group. Thirty patients with moderate-to-severe OSAS underwent continuous positive airway pressure treatment. Resistin levels and vascular endothelial function [endothelin 1 （ET 1）, nitric oxide （NO）, antithrombin-Ⅲ（AT-Ⅲ）] before treatment and 6 months after treatment were observed. Results Compared with the resistin levels in the control group, there was a significant increase in the OSAS group. Moreover, there was a significant difference increase in the mild OSAS group, moderate group, and severe OSAS group. The resistin levels were positively correlated with ET-1, AT-Ⅲ and negatively with NO. Resistin levels, ET-1 and AT-Ⅲ were significantly decreased and NO increased after CPAP treatment. Conclusions Our study demonstrated that vascular endothelial function and resistin levels were closely correlated. The resistin levels was correlated with the severity of OSAS. A decrease in resistin levels is helpful in the prevention and treatment of OSAS.