Lederer D J, Jelic S, Basner R C, Ishizaka A, Bhattacharya J
Dept of Medicine, Columbia University, New York, NY 10032, USA.
Eur Respir J. 2009 Apr;33(4):793-6. doi: 10.1183/09031936.00150708.
In obstructive sleep apnoea (OSA), oxidative stress contributes to endothelial dysfunction in the peripheral circulation. In the lung, oxidative stress can lead to alveolar injury. The present authors hypothesised that patients with OSA would have biomarker evidence of increased alveolar wall permeability. Sleep characteristics, brachial artery flow-mediated dilation and plasma KL-6 levels were observed in 11 otherwise healthy patients with OSA and 10 controls. Median (interquartile range) plasma KL-6 levels were higher in patients with OSA compared with controls: 317 (232-506) U.mL(-1) versus 226 (179-257) U.mL(-1), respectively. Higher plasma KL-6 levels were associated with greater time spent asleep with an oxyhaemoglobin saturation <90%, lower nadir saturation, more frequent desaturation of >4% during sleep and lower brachial artery flow-mediated dilation. Adjustment for nadir saturation or flow-mediated dilation attenuated the association between plasma KL-6 levels and OSA. Circulating KL-6 levels are elevated in some patients with obstructive sleep apnoea, possibly reflecting increased alveolar wall permeability.
在阻塞性睡眠呼吸暂停（OSA）中，氧化应激会导致外周循环中的内皮功能障碍。在肺部，氧化应激可导致肺泡损伤。本研究作者推测，OSA患者会有肺泡壁通透性增加的生物标志物证据。观察了11名其他方面健康的OSA患者和10名对照者的睡眠特征、肱动脉血流介导的舒张功能以及血浆KL-6水平。与对照组相比，OSA患者的血浆KL-6水平中位数（四分位间距）更高：分别为317（232 - 506）U.mL⁻¹和226（179 - 257）U.mL⁻¹。较高的血浆KL-6水平与氧合血红蛋白饱和度<90%时的睡眠时间更长、最低饱和度更低、睡眠期间>4%的更频繁去饱和以及更低的肱动脉血流介导的舒张功能相关。对最低饱和度或血流介导的舒张功能进行调整后，血浆KL-6水平与OSA之间的关联减弱。一些阻塞性睡眠呼吸暂停患者的循环KL-6水平升高，这可能反映了肺泡壁通透性增加。
