老年阻塞性睡眠呼吸暂停低通气综合征患者颈动脉弹性与氧化应激反应的关系

Relationship between carotid artery elasticity and oxidative stress in elderly patients with obstructive sleep apnea syndrome patients with obstructive sleep apnea syndrome

目的 探讨老年阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者颈动脉弹性与氧化应激反应的关系。方法选择2018年2月~2020年6月在重庆市长寿区人民医院接诊的老年OSAHS患者93例作为病例组,以性别进行1∶1配对选择体检的非OSAHS老年人93名为对照组进行前瞻性研究,比较两组颈动脉弹性指标及氧化应激指标。根据睡眠呼吸暂停低通气指数(AHI)将病例组分为3组,比较不同严重程度患者颈动脉弹性指标及氧化应激指标,并对颈动脉弹性指标及氧化应激指标进行相关性分析。结果 病例组患者血管扩张度(vascular expansion,VE)和顺应性系数(compli-ance coefficient,CC)均低于对照组,僵硬度系数β、脉搏波传播速度(pulse wave velocity,PWV)及丙二醛水平均高于对照组,超氧化物歧化酶及谷胱甘肽过氧化物酶水平均低于对照组(P均<0.05)。VE、CC、丙二醛均随患者病情严重程度的升高而降低,僵硬度系数β、PWV、超氧化物歧化酶、谷胱甘肽过氧化物酶均随病情严重程度的升高而升高(P<0.05)。相关性分析结果显示丙二醛与VE和CC均呈显著负相关(r=-0.582、-0.615,P均<0.05),与僵硬度系数β、PWV呈显著正相关(r=0.533、0.720,P均<0.05),超氧化物歧化酶、谷胱甘肽过氧化物酶均与VE、CC呈显著正相关(r=0.527、0.395、0.511、0.382,P均<0.05),与僵硬度系数β、PWV呈显著负相关(r=-0.581、-0.624、-0.602、-0.705,P均<0.05)。结论 老年OSAHS患者均出现不同程度的氧化应激反应及颈动脉弹性改变且患者颈动脉弹性与氧化应激反应呈一定的相关性。

OBJECTIVE To investigate the relationship between carotid artery elasticity and oxidative stress in elderly patients with obstructive sleep apnea hypopnea syndrome(OSAHS).METHODS We selected 93 elderly OSAHS patients who were admitted to our hospital from February 2018 to June 2020 as the case group,and 93 non-OSAHS elderly people who underwent 1:1 matching physical examination by gender as the control group for prospective study.The indexes of carotid elasticity and oxidative stress were compared between the two groups.According to the sleep apnea hypopnea index(AHI),the case groups were divided into three subgroups.The carotid elasticity indexes and oxidative stress indexes of patients with different severity of OSAHS were compared,and the correlation between carotid elasticity indexes and oxidative stress indexes was analyzed.RESULTS The vascular expansion(VE) and compli-ance coefficient(CC) of the case group were lower than those of the control group,the stiffness coefficient β,pulse wave velocity(PWV) and malondialdehyde levels were higher than those of the control group,and the superoxide dismutase and glutathione peroxidase levels were lower than that in the control group(P<0.05).The VE,CC and malondialdehyde of elderly OSAHS patients all decreased with the severity of the OSAHS.The stiffness coefficient β and PWV,superoxide dismutase,and glutathione peroxidase all increased with the severity of the disease(P<0.05).The results of correlation analysis showed that malondialdehyde was significant negatively correlated with VE and CC(r=-0.582,-0.615,P<0.05),and was significant positively correlated with stiffness coefficient β and PWV(r=0.533,0.720,P<0.05).Superoxide dismutase and glutathione share oxidase were significant positively correlated with VE and CC(r=0.527,0.395,0.511,0.382,P<0.05),and significant negatively correlated with stiffness coefficient β and PWV(r=-0.581,-0.624,-0.602,-0.705,P<0.05).CONCLUSION Elderly OSAHS patients have different degrees of oxidative stress and carotid artery elasticity changes,and there is a certain correlation between carotid artery elasticity and oxidative stress.