Zhong Xu, Xiao Yi, Huang Rong
Chin Med Sci J. 2013 Jan;27(4):237-42. doi: 10.1016/s1001-9294(13)60008-5.
Objective To study the effects of obstructive sleep apneas on endothelial function and autonomic modulation. Methods From June 2009 to June 2011, male patients with obstructive sleep apnea hypopnea syndrome (OSAHS) were consecutively enrolled in this study. Patients with an apnea/hypopnea index (AHI) of greater than 15 and without previous treatment for OSAHS were included as Group OSAHS and obese subjects with an AHI of less than 5 were included as non-OSAHS controls (Group Control). Electrocardiography and beat-to-beat blood pressure were continuously recorded from the radial artery by applanation tonometry which was synchronized with polysomnography recording. Endothelial function was measured by arterial augmentation index (AAI). Spectral analysis of heart rate variability (HRV) and blood pressure variability (BPV) were computed for cardiac parasympathetic modulation (high frequency power, HF); sympathetic modulation (low frequency power, LF), sympathovagal balance (LF/HF power of R-R variability, LF/HF) and BPV sympathetic modulation (BPV LF) in normalized units [total power of the components/(total power-very LF power)×100]. Results Finally, 27 moderate-severe OSAHS patients and 22 non-OSAHS obese controls were recruited in the Group OSAHS and Group Control, respectively. In Group OSAHS, the age was 43.3±9.3 year-old, body mass index (BMI) was 36.8±8.7 kg/m2; in Group Control, the age was 42.9±8.6 year-old, BMI was 34.4±7.9 kg/m2; there were no significant differences in age and BMI between the Group OSAHS and Group Control (all P>0.05). The baseline AAI (12.5%±2.2% vs. 8.2%±2.1%) and BPV LF (68.3%±13.5% vs. 61.1%±11.7%) of the Group OSAHS were significantly higher than those of the Group Control (all P<0.05). And after overnight sleep, systolic BP (143.7±14.2 vs. 132.8±13.3 mm Hg), diastolic BP (87.7±7.7 vs. 78.6±5.5 mm Hg), HRV LF (69.7%±14.4% vs. 64.3%±12.1%), HRV LF/HF (3.7±2.0 vs. 2.3±1.3) and BPV LF (77.8%±15.6% vs. 68.3%±13.5%) of the Group OSAHS were significantly increased (all P<0.001), while HRV HF was significantly decreased (21.1%±9.3% vs. 27.5%±10.3%, P<0.05) from baseline.
目的 研究阻塞性睡眠呼吸暂停对内皮功能和自主神经调节的影响。方法 2009年6月至2011年6月，连续纳入阻塞性睡眠呼吸暂停低通气综合征（OSAHS）男性患者。呼吸暂停/低通气指数（AHI）大于15且未曾接受过OSAHS治疗的患者纳入OSAHS组，AHI小于5的肥胖受试者作为非OSAHS对照组（对照组）。通过与多导睡眠图记录同步的压平式眼压计从桡动脉连续记录心电图和逐搏血压。通过动脉增强指数（AAI）测量内皮功能。计算心率变异性（HRV）和血压变异性（BPV）的频谱分析，用于心脏副交感神经调节（高频功率，HF）；交感神经调节（低频功率，LF）、交感迷走神经平衡（RR变异性的LF/HF功率，LF/HF）和以标准化单位表示的BPV交感神经调节（BPV LF）[各成分的总功率/（总功率 - 极低频率功率）×100]。结果 最终，OSAHS组和对照组分别招募了27例中重度OSAHS患者和22例非OSAHS肥胖对照。OSAHS组年龄为43.3±9.3岁，体重指数（BMI）为36.8±8.7kg/m²；对照组年龄为42.9±8.6岁，BMI为34.4±7.9kg/m²；OSAHS组和对照组之间年龄和BMI无显著差异（均P>0.05）。OSAHS组的基线AAI（12.5%±2.2%对8.2%±2.1%）和BPV LF（68.3%±13.5%对61.1%±11.7%）显著高于对照组（均P<0.05）。过夜睡眠后OSAHS组的收缩压（143.7±14.2对132.8±13.3mmHg）、舒张压（87.7±7.7对78.6±5.5mmHg）、HRV LF（69.7%±14.4%对64.3%±12.1%）、HRV LF/HF（3.7±2.0对2.3±1.3）和BPV LF（77.8%±15.6%对68.3%±13.5%）显著升高（均P<0.001），而HRV HF较基线显著降低（21.1%±9.3%对27.5%±10.3%，P<0.05）。
