血清TNF-α和HIF-1α水平与高血压合并中重度OSAHS的关系及nCPAP治疗对其的影响

Correlation between Serum HIF-1α/TNF-α Level and Hypertension Patients with Moderate to Severe OSAHS and the Effect of nCPAP Therapy

目的:观察经鼻持续正压通气(nCPAP)对高血压合并中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清肿瘤坏死因子α(TNF-α)、缺氧诱导因子-1α(HIF-1α)水平的影响。方法:42例高血压合并中重度OSAHS患者为研究组,40例单纯高血压患者为高血压组,同期20例体检正常者为对照组;于入院或者体检时采用酶联免疫吸附实验法(ELISA)检测3组受试者血清TNF-α及HIF-1α的水平;研究组患者再均分为常规治疗组(常规药物治疗)及联合治疗组(常规药物治疗联合nCPAP治疗),分别检测治疗前、治疗1个月及6个月时血清TNF-α及HIF-1α水平,并记录AHI值及血压。结果:3组被检者血清TNF-α及HIF-1水平研究组>高血压组>对照组,差异有统计学意义(P <0. 05);治疗后,联合治疗组AHI值、血压及血清TNF-α、HIF-1α水平均较常规治疗组降低,差异有统计学意义(P <0. 05);治疗后,联合治疗组患者AHI值、血压及血清TNF-α、HIF-1α水平均较治疗前显著降低(P <0. 05),且治疗6个月时的数值显著低于治疗1个月(P <0. 05);常规治疗组患者仅治疗6个月时血压、血清TNF-α均较治疗前显著降低,差异有统计学意义(P <0. 05);其余指标比较差异无统计学意义(P> 0. 05)。结论:常规治疗联合nCPAP对高血压合并OSAHS患者的治疗效果可能与降低患者血液TNF-α及HIF-1α水平有关。

Objective:To investigate the curative effects and prognosis of nasal continuous positive airway pressure(nCPAP)treatment by observing the levels of hypoxia-inducible factor-1α(HIF-1α)and TNF-αin hypertension patients with moderate to severe obstructive sleep apnea hypopnea syndrome(OSAHS).Method:42 hypertension patients with moderate to severe OSAHS were chosen as study group.40 hypertension patients without OSAHS as hypertension group.In addition,20 people received physical examination were chosen as blank group.The expression of TNF-αand HIF-1αlevels of all groups were detected by ELISA when admitted to hospital or during physical check.Patients in the study group were equally and randomly divided into conventional study group(conventional drug therapy)and combined study group(conventional drug therapy combined with nCPAP therapy).Serum TNF-αand HIF-1αlevel were detected before treatment,1 month and 6 months after treatment;blood pressure and AHI value were recorded.Results:HIF-1αand TNF-αlevel in decreasing order as,study group,simple hypertension and blank group,differences were statistically significant(P<0.05);after treatment,AHI value,blood pressure and serum HIF-1αand TNF-αlevel of combined treatment group was lowered than conventional treatment group,differences were statistically significant(P<0.05);after treatment,AHI value,blood pressure and serum HIF-1αand TNF-αlevel of combined treatment group was significantly lowered than before treatment(P<0.05),and the value of 6 months after treatment was significantly lower than that of one month(P<0.05);blood pressure and serum TNF-αof conventional treatment group 6 months after treatment were obviously lowered than before treatment,differences were statistically significant(P<0.05);other parameters were not statistically significant(P<0.05).Conclusions:The efficacy of conventional treatment combined nCPAP on hypertension patient with OSAHS might be related with the patients'serum HIF-1αand HIF-1α.