[阻塞性睡眠呼吸暂停低通气综合征合并高血压患者血清内皮素-1水平及睡眠结构变化的评估]

[Evaluation of the serum endothelin-1 level and sleep architecture change in patients with obstructive sleep apnea hypopnea syndrome accompanied hypertension].

作者信息

Li Yan-zhong, Wang Ting-chu, Lu Hong-xia, Wang Xin, Wang Yan, Zhang Bing-feng

机构信息

State Otorhinolaryngology Institute of China Shandong University, Jinan 250012, China.

出版信息

Zhonghua Er Bi Yan Hou Ke Za Zhi. 2004 Feb;39(2):116-9.

DOI:

PMID:15195597

Abstract

OBJECTIVE

To explore the role of endothelin-1 (ET-1) in the pathogenesis of hypertension in obstructive sleep apnea hypopnea syndrome (OSAHS).

METHODS

The levels of serum ET-1 in 30 OSAHS patients accompanied by hypertension, 30 normotensive OSAHS patients and 30 healthy controls were measured by ET-1 enzyme immunoassay kit. Meanwhile the correlation about the concentration of ET-1 in OSAHS patients with the clinic, polysomnography (PSG) parameters was analyzed.

RESULTS

OSAHS patients with or without hypertension compared with snoring group and normal people, the sleep structure was significantly disturbed. The time percentages of awake and stage I sleep were increased, while stage II sleep decreased significantly in OSAHS patients than those in snoring group (P < 0.01, respectively). There were no significantly difference about the sleep structure in the two OSAHS groups. The levels of serum ET-1 (mean +/- s) were significantly higher in OSAHS patients accompanied by hypertension and normotensive OSAHS patients(42.5 +/- 8.4) ng/L and (38.6 +/- 4.7) ng/L respectively than those in the healthy controls(33.1 +/- 5.4) ng/L (P < 0.01, respectively). In the two OSAHS groups, the levels of serum ET-1 were significantly higher in OSAHS patients accompanied by hypertension than those in the normotensive OSAHS patients (P < 0.05). There were positive correlations between the concentration of ET-1 and the apnea hypopnea index (AHI) in all the 60 OSAHS patients with and without hypertension (r = 0.334, P < 0.01). There were negative correlations between the concentration of ET-1 and the lowest oxygen desaturation in all the 60 OSAHS patients with and without hypertension (r = -0.230, P < 0.05).

CONCLUSION

These results indicate that the sleep disordered breathing and hypoxia may contribute to the elevation of ET-1 in the OSAHS patients and OSAHS patients accompanied by hypertension. ET-1 may play an important role in the pathogenesis of OSAHS-induced hypertension.

摘要

目的

探讨内皮素-1（ET-1）在阻塞性睡眠呼吸暂停低通气综合征（OSAHS）高血压发病机制中的作用。

方法

采用ET-1酶免疫分析试剂盒检测30例伴高血压的OSAHS患者、30例血压正常的OSAHS患者和30例健康对照者的血清ET-1水平。同时分析OSAHS患者ET-1浓度与临床及多导睡眠图（PSG）参数的相关性。

结果

伴或不伴高血压的OSAHS患者与打鼾组及正常人相比，睡眠结构明显紊乱。OSAHS患者清醒和I期睡眠的时间百分比增加，而II期睡眠较打鼾组明显减少（分别为P < 0.01）。两组OSAHS患者的睡眠结构无明显差异。伴高血压的OSAHS患者和血压正常的OSAHS患者血清ET-1水平（均值±标准差）分别为（42.5±8.4）ng/L和（38.6±4.7）ng/L，显著高于健康对照者（33.1±5.4）ng/L（分别为P < 0.01）。在两组OSAHS患者中，伴高血压的OSAHS患者血清ET-1水平显著高于血压正常的OSAHS患者（P < 0.05）。在所有60例伴或不伴高血压的OSAHS患者中，ET-1浓度与呼吸暂停低通气指数（AHI）呈正相关（r = 0.334，P < 0.01）。在所有60例伴或不伴高血压的OSAHS患者中，ET-1浓度与最低氧饱和度呈负相关（r = -0.230，P < 0.05）。