Jurado-Gamez Bernabe, Bujalance Cabrera Carlos, Caballero Ballesteros Laura, Marin Hinojosa Carmen, Muñoz Cabrera Luis, Perez-Jimenez Francisco, Lopez-Miranda Jose
Sleep Unit, Department of Pulmonary Medicine, Reina Sofia University Hospital, Spain.
Intern Med. 2012;51(4):363-8. doi: 10.2169/internalmedicine.51.6571. Epub 2012 Feb 15.
To evaluate the impact of oxidative stress and cellular adhesion molecules on ischemic reactive hyperemia (IRH) in patients with OSA.
Consecutive patients treated at a sleep laboratory and whose polysomnography showed an apnea hypopnea index (AHI) ≥5 were included in the study. Patients with acute illness receiving vasoactive medications were excluded. Based on their oxygen desaturation index (ODI), subjects were assigned to the mild-moderate (ODI ≤30) or the severe desaturation group (ODI >30). Then IRH and oxidative stress markers [malondialdehyde (MDA)] and proinflammatory markers (ICAM-1 and P-selectin) were measured.
Sixty-eight subjects with OSA were included, 31 in the mild-moderate desaturation group and 37 in the severe group. No differences by age, gender and body mass index were observed. The severe desaturation group showed significantly higher values in the AHI, MDA, ICAM-1 and P-selectin (p<0.005), as well as a worsening of IRH (p=0.001). Only ICAM-1 (p=0.019) and P-selectin (p=0.033) were independently associated with IRH in a multiple-linear regression model.
Patients with OSA and greater intermittent hypoxia showed worse endothelial function, and higher levels of MDA, ICAM-1 and P-selectin. Nevertheless, ICAM-1 and P-selectin rather than MDA were independently associated with IRH.
评估氧化应激和细胞黏附分子对阻塞性睡眠呼吸暂停（OSA）患者缺血性反应性充血（IRH）的影响。
纳入在睡眠实验室接受治疗且多导睡眠图显示呼吸暂停低通气指数（AHI）≥5的连续患者。排除正在接受血管活性药物治疗的急性病患者。根据氧去饱和指数（ODI），将受试者分为轻-中度组（ODI≤30）或重度去饱和组（ODI>30）。然后测量IRH、氧化应激标志物[丙二醛（MDA）]和促炎标志物（ICAM-1和P-选择素）。
纳入68例OSA患者，轻-中度去饱和组31例，重度组37例。未观察到年龄、性别和体重指数方面的差异。重度去饱和组的AHI、MDA、ICAM-1和P-选择素值显著更高（p<0.005），且IRH更严重（p=0.001）。在多元线性回归模型中，只有ICAM-1（p=0.019）和P-选择素（p=0.033）与IRH独立相关。
OSA和间歇性缺氧程度较重的患者内皮功能较差，MDA、ICAM-1和P-选择素水平较高。然而，与IRH独立相关的是ICAM-1和P-选择素，而非MDA。
