Kitahara Yoshihiro, Hattori Noboru, Yokoyama Akihito, Nakajima Masamitsu, Kohno Nobuoki
Department of Molecular and Internal Medicine, Division of Clinical Medical Science, Graduate School of Biochemical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Respir Med. 2006 Dec;100(12):2160-9. doi: 10.1016/j.rmed.2006.03.015. Epub 2006 May 2.
Pulse wave velocity (PWV) is a good indicator of arterial stiffness and an important predictor of cardiovascular events. Recent studies have revealed that PWV increases in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and it also correlates with its severity. However, the therapeutic effect of continuous positive airway pressure (CPAP) on PWV remains undetermined. To clarify this point, we started CPAP treatment on 17 OSAHS patients. Brachial-ankle PWV was measured before starting CPAP, and at 2 months and 4 months after the start of CPAP. Before the CPAP treatment, mean brachial-ankle PWV of the patients was 15.6+/-0.6 m/s, and mean Epworth sleepiness scale (ESS) score was 8.6+/-1.0. Brachial-ankle PWV was found to positively correlate with heart rate, systolic and diastolic blood pressures, mean blood pressure, and arousal index. During the study period, the CPAP treatment did not have a significant effect on heart rate, blood pressures and serum total cholesterol levels. However, it significantly improved ESS score at 4 months after the start of CPAP (P=0.001), while it effectively decreased brachial-ankle PWV at 2 months and at 4 months after the start of CPAP (P=0.010 and P=0.027, respectively). The CPAP treatment was shown to decrease brachial-ankle PWV without affecting blood pressures in OSAHS patients. Although the precise mechanism for this effect is unclear, our finding suggests a close relationship between OSAHS and arterial stiffness, while also reemphasizing the clinical importance of CPAP treatment.
脉搏波速度（PWV）是动脉僵硬度的良好指标，也是心血管事件的重要预测因子。最近的研究表明，阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的PWV会升高，并且它还与其严重程度相关。然而，持续气道正压通气（CPAP）对PWV的治疗效果仍不确定。为了阐明这一点，我们对17例OSAHS患者开始了CPAP治疗。在开始CPAP治疗前、开始治疗后2个月和4个月测量肱踝PWV。在CPAP治疗前，患者的平均肱踝PWV为15.6±0.6米/秒，平均爱泼沃斯嗜睡量表（ESS）评分为8.6±1.0。发现肱踝PWV与心率、收缩压和舒张压、平均血压以及觉醒指数呈正相关。在研究期间，CPAP治疗对心率、血压和血清总胆固醇水平没有显著影响。然而，在开始CPAP治疗4个月后，它显著改善了ESS评分（P = 0.001），而在开始CPAP治疗2个月和4个月后，它有效地降低了肱踝PWV（分别为P = 0.010和P = 0.027）。结果表明，CPAP治疗可降低OSAHS患者的肱踝PWV，而不影响血压。虽然这种作用的确切机制尚不清楚，但我们的发现提示了OSAHS与动脉僵硬度之间的密切关系，同时也再次强调了CPAP治疗的临床重要性。
