持续气道正压通气治疗对阻塞性睡眠呼吸暂停—低通气综合征患者血浆一氧化氮、内皮素1和可溶性P选择素水平的影响
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浙江省医药卫生科学研究基金(2003B018)


Effect of Continuous Positive Airway Pressure Treatment on Blood Concentration of Nitric Oxide,Endothelin-1 and Soluble P-Selectin in Patients with Obstructive Sleep Apnea/Hyponea Syndrome
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    摘要:

    目的探讨阻塞性睡眠呼吸暂停/低通气综合征患者血浆一氧化氮、内皮素1和可溶性P选择素水平的变化及持续气道正压通气治疗对其的影响。方法持续气道正压通气治疗前后分别采用硝酸盐还原酶法、放射免疫均相竞争分析法和酶联免疫法测定阻塞性睡眠呼吸暂停—低通气综合征患者血一氧化氮、内皮素1和可溶性P-选择素水平。结果阻塞性睡眠呼吸暂停/低通气综合征患者血一氧化氮水平(63.41±27.68μmol/L)明显低于健康对照者(83.26±47.74μmol/L),内皮素1水平(71.56±23.33μg/L)和可溶性P选择素水平(131.13±77.93mg/L)明显高于健康对照者(58.49±15.02μg/L和32.90±55.73mg/L);但阻塞性睡眠呼吸暂停/低通气综合征患者血一氧化氮水平明显高于伴有心脑血管疾病患者(59.59±34.19μmol/L),内皮素1水平和可溶性P选择素水平明显低于伴有心脑血管疾病患者(89.01±44.87μg/L和160.83±125.45mg/L)。持续气道正压通气治疗可明显提高一氧化氮水平(60.46±23.53μmol/L比75.11±23.91μmol/L)、降低内皮素1(73.60±20.78μg/L比61.84±18.79mg/L)和可溶性P选择素(137.34±90.35μg/L比89.56±34.60mg/L)水平(p<0.05)。结论阻塞性睡眠呼吸暂停/低通气综合征患者无论是否合并心脑血管疾病,血浆一氧化氮、内皮素1和可溶性P选择素均存在明显异常;而持续气道正压通气治疗可有效纠正其异常。

    Abstract:

    Aim To observe the levels of nitric oxide,endothelin-1 and soluble P-selectin in patients with obstructive sleep apnea/hyponea syndrome and determine whether continuous positive airway pressure treatment has effect on them.Methods Blood concentration of nitric oxide,endothelin-1 and soluble P-selectin,the markers of vascular endothelial cell function,were determined by nitrate reductase,radioimmunoassay,and enzyme-linked immunoassay,respectively.Results Compared with healthy controls(83.26±47.74 μmol/L,58.49±15.02 ng/L and 32.90±55.73 mg/L;respectively),the levels of nitric oxide,endothelin-1 and soluble P-selectin both in patients without cardiovascular disease(63.41±27.68 μmol/L,71.56±23.33 ng/L and 131.13±77.93 mg/L;p<0.05)and in those with cardiovascular disease(59.59±34.19 μmol/L,89.01±44.87 ng/L and 160.83±125.45 mg/L;p<0.05)were significantly changed.However,after continuous positive airway pressure treatment,the blood concentration of nitric oxide(60.46±23.53 μmol/L vs 75.11±23.91 μmol/L;P=0.025),endothelin-1(73.60±20.78 ng/L vs 61.84±18.79 ng/L;P=0.031)and soluble P-selectin(137.34±90.35 mg/L vs 89.56±34.60 mg/L;P=0.013)were significantly improved.Conclusions Obstructive sleep apnea/hyponea syndrome patients,no matter whether complicated by cardiovascular diseases or not,have significant vascular endothelial cell dysfunction,which can be improved through the continuous positive airway pressure treatment.

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王国付,钦光跃,吴健,吴金彦,顾亮.持续气道正压通气治疗对阻塞性睡眠呼吸暂停—低通气综合征患者血浆一氧化氮、内皮素1和可溶性P选择素水平的影响[J].中国动脉硬化杂志,2007,15(1):54~56.

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  • 收稿日期:2006-08-24
  • 最后修改日期:2006-12-01