经鼻持续气道正压通气对中、重度阻塞型睡眠呼吸暂停综合征患者血清细胞间黏附分子的影响

Effects of continuously nasal positive airway pressure on intercellular adhesion molecule-1 in patients with moderate to severe obstructive sleep apnea syndrome

目的 细胞间黏附分子 (ICAM) - 1被认为是动脉粥样硬化和冠心病的重要危险因素。本研究比较中、重度阻塞型睡眠呼吸暂停综合征 (OSAS)患者经鼻持续气道正压通气 (nCPAP)短期治疗前后血清I CAM - 1水平有无差别。方法 选择通过多导睡眠图 (PSG)确诊的 2 2例中、重度OSAS患者 (中度 9名、重度13名 )和 15例对照者 (无OSAS者 6名、轻度OSAS患者 9名 ) ,用ELISA法测定其血清ICAM - 1水平 ,并对2 2例中、重度OSAS患者行nCPAP治疗 4d ,观察血清ICAM - 1有无变化 ,同时对相关数据进行统计分析。结果 OSAS患者ICAM - 1水平与其AHI呈正相关 (r=0 .36 9,P =0 .0 2 9) ,与夜间最低SaO2 早负相关 (r =- 0 .34,P =0 .0 4 5 ) ;中、重度OSAS患者ICAM - 1水平较对照者高 [(171.7± 5 7.7)ng/mlvs (138.7± 16 .9)ng/ml,P =0 .0 4 6 ];中、重度OSAS患者治疗后血清ICAM - 1水平明显降低 [(171.7± 5 7.7)ng/mlvs (14 9.4± 4 1.7)ng/ml,P =0 .0 2 2 ]。结论 中、重度OSAS患者血清ICAM - 1水平升高 ;nCPAP短期治疗中、重度OSAS能降低血清ICAM - 1水平。

Objective: Intercellular adhesion molecule (ICAM)-1 is an important risk factor for atherosclerosis and coronary artery disease (CAD).We investigated the effects of nasal continuous positive airway pressure (nCPAP) treatment on serum level of ICAM-I in moderate to severe obstructive sleep apnea syndrome (OSAS) patients. Methods:After polysomnograph (PSG),venous bloods was collected from 22 patients with moderate to severe OSAS(9 moderate patients and 13 severe patients) and 15 control subjects(6 subjects without OSAS and 9 OSAS patients). Serum level of ICAM-1 was investigated. In addition, the effects of 4 days of nCPAP were studied in patients with moderate to severe OSAS. Results: The level of ICAM-1 was significantly higher in patients with moderate to severe OSAS than that in control subjects[ (171.7±57.7) vs (138.7± 16.9), P=0.046]. Before treatment, there were significantly positive correlation between ICAM-1 and AHI in OSAS patients(r=0.369,P= 0.029) and significantly negative correlation between ICAM-1 and the lowest nocturnal oxygen saturation (SaO 2) (r=-0.34,P=0.045). nCPAP significantly decreased the level of ICAM-1 in patients with moderate to severe OSAS[( 171.7±57.7) vs (149.4±41.7), P=0.022] .Conclusions:The level oflCAM-1 is higher in patients with moderate to severe OSAS and can be decreased by nCPAP.