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持续气道正压通气治疗对男性阻塞性睡眠呼吸暂停低通气综合征患者血清脂联素水平及平均动脉压的影响

Effect of continuous positive airway pressure treatment on serum adiponectin level and mean arterial pressure in male patients with obstructive sleep apnea syndrome.

作者信息

Zhang Xi-long, Yin Kai-sheng, Li Chong, Jia En-zhi, Li Yan-qun, Gao Zhao-fang

机构信息

Departmemt of Respiratory Medicine, First Affliated Hospital of Nanjing Medical University, Nanjing 210029, China.

出版信息

Chin Med J (Engl). 2007 Sep 5;120(17):1477-81.

Abstract

BACKGROUND

Recent research suggested that obstructive sleep apnea syndrome (OSAS) might be independently associated with hypoadiponectinemia, which was linked to some complications of OSAS, such as hypertension, diabetes, etc. This study was conducted to investigate the effect of continuous positive airway pressure (CPAP) treatment on changes of both serum adiponectin levels and mean arterial pressure and their possible links in male OSAS patients.

METHODS

Twenty-three adult male patients with moderate-to-severe OSAS but without obesity, coronary heart disease and diabetes were recruited. Their blood samples were collected and morning mean arterial pressure (MAP) was measured before CPAP treatment and on day 3, 7, 14 of CPAP treatment respectively. The serum adiponectin concentration was tested with radioimmunoassay.

RESULTS

Compared with the serum adiponectin level before CPAP treatment, no significant change was found in OSAS patients on day 3 and day 7 of CPAP treatment (P > 0.05). It was not until day 14 of CPAP treatment did a significant elevation in serum adiponectin level occur (P < 0.01). Meanwhile, the MAP showed no statistically significant difference among its levels before CPAP, on day 3 and day 7 of CPAP treatment (P > 0.05). However, on day 14 of CPAP treatment, a significantly lower MAP than that obtained before treatment was observed (P < 0.05).

CONCLUSIONS

CPAP treatment can gradually reverse hypoadiponectinemia and reduce MAP in OSAS patients. Hypoadiponectinemia might be involved in the pathogenesis of OSAS-mediated hypertension.

摘要

背景

近期研究表明,阻塞性睡眠呼吸暂停综合征(OSAS)可能与低脂联素血症独立相关,而低脂联素血症与OSAS的一些并发症有关,如高血压、糖尿病等。本研究旨在探讨持续气道正压通气(CPAP)治疗对男性OSAS患者血清脂联素水平变化、平均动脉压及其可能关联的影响。

方法

招募23例成年男性中重度OSAS患者,这些患者无肥胖、冠心病和糖尿病。在CPAP治疗前、治疗第3天、第7天和第14天分别采集他们的血样并测量早晨平均动脉压(MAP)。采用放射免疫法检测血清脂联素浓度。

结果

与CPAP治疗前的血清脂联素水平相比,OSAS患者在CPAP治疗第3天和第7天未发现显著变化(P>0.05)。直到CPAP治疗第14天,血清脂联素水平才出现显著升高(P<0.01)。同时,CPAP治疗前、治疗第3天和第7天的MAP水平之间无统计学显著差异(P>0.05)。然而,在CPAP治疗第14天,观察到MAP显著低于治疗前(P<0.05)。

结论

CPAP治疗可逐渐逆转OSAS患者的低脂联素血症并降低MAP。低脂联素血症可能参与OSAS介导的高血压发病机制。

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