Schulz Richard, Hummel Christoph, Heinemann Sabine, Seeger Werner, Grimminger Friedrich
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Justus-Liebig-University, Giessen, Germany.
Am J Respir Crit Care Med. 2002 Jan 1;165(1):67-70. doi: 10.1164/ajrccm.165.1.2101062.
Obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality; however, some patients with OSA do not develop cardiovascular disease even in the presence of severe nocturnal oxygen desaturations. Vascular endothelial growth factor (VEGF) is a hypoxia-sensitive glycoprotein stimulating neoangiogenesis. We hypothesized that VEGF production is increased in OSA because of repetitive nocturnal hypoxia. Three different groups were investigated: 10 OSA patients with severe nighttime hypoxia (Group A), 10 OSA patients with moderate hypoxia (Group B), and 10 healthy volunteers (Group C). Serum levels of VEGF were measured by ELISA from peripheral venous blood samples obtained at 7 AM. Group A had significantly (p < 0.01) increased VEGF serum levels when compared with Group B and Group C (mean +/- SEM: 410 +/- 77 pg/ml versus 224 +/- 38 pg/ml and 245 +/- 61 pg/ml). The degree of nocturnal oxygen desaturation in OSA significantly correlated with the VEGF concentrations (r = 0.67, p < 0.01). In conclusion, serum levels of VEGF are elevated in severely hypoxic patients with OSA and are related to the degree of nocturnal oxygen desaturation. This might constitute an adaptive mechanism to counterbalance the emergence of OSA-related cardiovascular disease.
阻塞性睡眠呼吸暂停（OSA）与心血管疾病发病率和死亡率的增加相关；然而，一些OSA患者即使存在严重的夜间氧饱和度下降也不会发生心血管疾病。血管内皮生长因子（VEGF）是一种对缺氧敏感的糖蛋白，可刺激新血管生成。我们推测，由于夜间反复缺氧，OSA患者体内VEGF的产生会增加。我们对三个不同的组进行了研究：10名伴有严重夜间缺氧的OSA患者（A组）、10名伴有中度缺氧的OSA患者（B组）和10名健康志愿者（C组）。通过酶联免疫吸附测定法（ELISA）测量上午7点采集的外周静脉血样本中的VEGF血清水平。与B组和C组相比，A组的VEGF血清水平显著升高（p < 0.01）（均值±标准误：410±77 pg/ml，而B组为224±38 pg/ml，C组为245±61 pg/ml）。OSA患者夜间氧饱和度下降的程度与VEGF浓度显著相关（r = 0.67，p < 0.01）。总之，伴有严重缺氧的OSA患者血清VEGF水平升高，且与夜间氧饱和度下降程度有关。这可能构成一种适应性机制，以平衡OSA相关心血管疾病的发生。
