Characteristics of glucolipid metabolism as well as atherosclerosis in patients with obstructive sleep apnea-hypopnea syndrome combined with cerebral infarction

Objective:To evaluate the characteristics of glucolipid metabolism as well as atherosclerosis in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) combined with cerebral infarction.Methods:Patients who were treated in the hospital due to acute cerebral infarction between March 2015 and February 2018 were selected, and according to the combination of OSAHS, the 300 patients with cerebral infarction were divided into the cerebral infarction group A who were combined with OSAHS and the cerebral infarction group B who were not combined with OSAHS;the 100 cases of healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. The contents of glucolipid metabolism indexes, cytokines and plaque hydrolysis molecules in serum were determined.Results: Serum F-Ins, TC, LDL-C, VE-cadherin, YKL-40, FKN, M-CSF, MCP-1, MMP9, Caspase-3, ICTP and VCAM-1 levels of cerebral infarction group A and cerebral infarction group B were significantly higher than those of control group whereas HDL-C levels were significantly lower than that of control group;serum F-Ins, TC, LDL-C, VE-cadherin, YKL-40, FKN, M-CSF, MCP-1, MMP9, Caspase-3, ICTP and VCAM-1 levels of cerebral infarction group A were significantly higher than those of cerebral infarction group B whereas HDL-C level was significantly lower than that of cerebral infarction group B.Conclusion: There are more significant glucolipid metabolism disorder and worse plaque stability in patients with OSAHS combined with cerebral infarction.

Relationship between obstructive sleep apnea-hypopnea syndrome(OSAHS)and liver fibrosis

Objective:The current study discusses the relationship between sleep apnea-hypopnea syn-drome(OSAHS)and liver fibrosis by determining the level of plasma hyaluronic acid(HA),pro-collagen III(PIII),collagen IV(IVC),and laminin(LN)in OSAHS patients and non-OSAHS patients with obesity and normal body weight.Methods:The patients who underwent polysomnographic(PSG)examinations in the outpatient and inpatient departments of our hospital between December 2010 and June 2013 were selected.The patients were divided into two groups based on the apnea-hypopnea index(AHI;OSAHS and non-OSAHS patients),and both groups were further divided based on obesity and normal body weight based on the body mass index(BMI).Sleep breathing indicators,including BMI,AHI,LSaO_(2),and MSaO_(2),were measured in all patients.All of the patients had their blood drawn on the morning after the day of the PSG examination,and the samples were sent to the biochemical laboratory of our hospital for determination of the levels of HA,PIII,IVC,and LN.Results:Among the obese and normoweight patients,the levels of HA,PIII,IVC,and LN in OSAHS patients were higher than the non-OSAHS patients(P value<0.05).Amongst the OSAHS and non-OSAHS patients,the levels of HA,PIII,IVC,and LN in the obese patients were also higher than the non-obese patients(P value<0.05).The levels of HA,PIII,IVC,and LN in the obese OSAHS patients were higher than the remaining three groups(P value<0.05).The levels of HA,PIII,IVC,and LN had positive correlations with the AHI and BMI(r=0.701,0.523,0.639,and 0.421,respectively,P<0.05;and r=0.565,0.441,0.475,and 0.401,respectively,P<0.05),and nega-tive correlations with the LSaO_(2) and MSaO_(2) in OSAHS patients(r=-0.432,-0.394,-0.403,and-0.267,respectively,P<0.05;and r=-0.591,-0.517,-0.533,and-0.484,respectively,P<0.05).Conclusion:The levels of plasma HA,PIII,IVC,and LN in OSAHS patients were related to OSAHS.OSAHS might lead to liver fibrosis.

暖心康抑制内皮间充质转化减轻阻塞性睡眠呼吸暂停低通气综合征合并动脉粥样硬化小鼠斑块形成

目的探讨暖心康(毛冬青、红参)通过抑制内皮间充质转化(EndMT)减轻阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并动脉粥样硬化(AS)小鼠斑块形成的作用及机制。方法将雄性ApoE^(-/-)小鼠随机分为6组:对照组、模型组、阿托伐他汀组(2.6 mg·kg^(-1))以及暖心康低、中、高剂量组(生药量3.5、7.0、14.0 g·kg^(-1)),每组8只。采用将小鼠长期在睡眠期间暴露于慢性间歇性缺氧(CIH)环境,联合高脂饲料喂养,复制OSAHS合并AS小鼠模型。采用油红O染色法观察小鼠主动脉内壁斑块形成情况;Masson三色染色法评估小鼠主动脉根部粥样斑块的胶原含量;免疫荧光法检测主动脉斑块中内皮细胞标志物CD31及EndMT标志物Vimentin的表达情况;ELISA法测定血脂水平;qPCR法检测主动脉组织中EndMT标志物α-SMA、Cdh2 mRNA表达水平。结果与对照组比较,模型组小鼠的主动脉粥样斑块面积显著增加(P<0.01),主动脉根部斑块胶原沉积面积显著增加(P<0.01);斑块处CD31阳性表达细胞数量显著减少(P<0.01),Vimentin阳性表达细胞数量显著增多(P<0.01);血清甘油三酯(TG)、总胆固醇(T-CHO)、低密度脂蛋白胆固醇(LDL-C)水平显著升高(P<0.01),高密度脂蛋白胆固醇(HDL-C)水平显著降低(P<0.01);主动脉组织中α-SMA、Cdh2 mRNA表达水平显著升高(P<0.01)。与模型组比较,暖心康各给药组的主动脉粥样斑块面积均显著减少(P<0.05,P<0.01),主动脉根部粥样斑块的胶原沉积面积均明显缩小(P<0.05,P<0.01);暖心康高剂量组小鼠斑块处CD31阳性表达细胞数量明显增加(P<0.05),暖心康中、高剂量组小鼠斑块处Vimentin阳性表达细胞数量明显减少(P<0.05,P<0.01);暖心康高剂量组小鼠的血清TG水平显著降低(P<0.01),暖心康各给药组小鼠的血清T-CHO、LDL-C水平显著降低(P<0.05,P<0.01),暖心康中、高剂量组小鼠的血清HDL-C水平显著升高(P<0.01);暖心康各给药组小鼠主动脉组织中α-SMA、Cdh2 mRNA表达水平显著降低(P<0.01)。结论暖心康可以有效减轻OSAHS合并动脉粥样硬化小鼠的斑块形成,可能与其抑制EndMT,减少胶原纤维形成有关。

慢性间歇性低氧动物模型的比较

阻塞性睡眠呼吸暂停低通气综合征(OSAHS)导致的慢性间歇性低氧(CIH)是引起或加重多种心脑血管病的重要病理因素。建立CIH动物模型,通过控制动物呼吸的环境气体氧浓度的方法模拟间歇性低氧条件,是研究CIH相关心血管疾病发病机制的重要方法之一。该文从实验动物、气体控制仪器、气体种类及浓度、间歇性低氧处理时间、缺氧循环模式等方面总结及对比了近年来CIH动物模型的造模方法,以求为OSAHS相关心血管疾病的动物实验研究提供参考。

H型高血压合并阻塞性睡眠呼吸暂停低通气综合征患者颈动脉硬化程度的临床分析

目的探讨H型高血压合并阻塞性睡眠呼吸暂停低通气综合征患者(OSAHS)的颈动脉硬化程度。方法选择2014年10月~2016年10月初次诊断为H型高血压的住院患者114例。患者均符合H型高血压诊断标准。根据OSAHS诊断标准分为对照组(58例)和H型高血压合并OSAHS组(56例)。颈动脉超声检查患者颈动脉内膜-中膜厚度(IMT)、斑块以及狭窄情况。检测患者血浆同型半胱氨酸(Hcy)、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇等生化指标。结果 H型高血压合并OSAHS组总胆固醇含量以及低密度脂蛋白胆固醇含量较对照组显著升高,差异有统计学意义(P<0.05)。H型高血压合并OSAHS组正常者比例显著低于对照组,颈动脉增厚26例,颈动脉斑块14例,颈动脉狭窄12例,所占比例略高于对照组(增厚18例,斑块13例,狭窄9例),差异无统计学意义(P>0.05)。结论 H型高血压合并OSAHS双重作用,颈动脉硬化程度较为严重,应重视H型高血压合并OSAHS患者颈动脉情况。