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持续气道正压通气治疗对阻塞性睡眠呼吸暂停综合征患者炎症因子及动脉粥样硬化的影响。

Effect of continuous positive airway pressure therapy on inflammatory cytokines and atherosclerosis in patients with obstructive sleep apnea syndrome.

机构信息

Department of Respiration, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, Jiangsu 211100, P.R. China.

Department of Respiratory, Jiangsu Province Official Hospital, Nanjing, Jiangsu 211100, P.R. China.

出版信息

Mol Med Rep. 2017 Nov;16(5):6334-6339. doi: 10.3892/mmr.2017.7399. Epub 2017 Aug 30.

DOI:10.3892/mmr.2017.7399
PMID:28901415
Abstract

Obstructive sleep apnea syndrome (OSAS) is known to be a risk factor for atherosclerosis (AS), derived from a series of chronic inflammatory reactions caused by hypoxia. However, the association between chronic inflammation and high blood pressure caused by hypoxia remains to be fully elucidated. The aim of the present study was to investigate the effect of continuous positive airway pressure (CPAP) therapy on inflammatory cytokines and AS. A total of 100 patients with OSAS and 50 healthy control subjects were enrolled. Fresh venous blood samples were collected prior to and following a 3‑months period of CPAP treatment. The inflammatory factors, interleukin (IL)‑18 and tumor necrosis factor (TNF)‑α, C‑reactive protein (CRP), intercellular cell adhesion molecule 1 (ICAM‑1), vascular cell adhesion molecule 1 (VCAM‑1), E‑selectin and P‑selectin, were detected using standard enzyme‑linked immunosorbent assay kits. Intima‑media thickness (IMT), brachial‑ankle pulse wave velocity (Ba‑PWV), apnea‑hypopnea index (AHI) and transcutaneous oxygen saturation (SpO2) were also detected to compare differences prior to and following treatment. The results showed that, compared with the pre‑treatment data, the expression levels of IL‑8, TNF‑α, CRP, ICAM‑1, VCAM‑1, E‑selectin and P‑selectin were significantly decreased following treatment (P<0.05). The AHI, IMT, blood pressure and Ba‑PWV values were significantly decreased (P<0.05), and the SpO2 was increased (P<0.05). Taken together, by comparing the pre‑ and post‑intervention data, it was confirmed that inflammatory factors were involved in the process of AS in patients with OSAS. Following CPAP treatment, blood pressure and primary indicators in the patients improved.

摘要

阻塞性睡眠呼吸暂停低通气综合征(OSAS)已知是动脉粥样硬化(AS)的一个风险因素,源于一系列由缺氧引起的慢性炎症反应。然而,缺氧引起的慢性炎症与高血压之间的关联仍有待充分阐明。本研究旨在探讨持续气道正压通气(CPAP)治疗对炎症因子和 AS 的影响。共纳入 100 例 OSAS 患者和 50 例健康对照者。在 CPAP 治疗前和治疗 3 个月后采集新鲜静脉血样本。采用标准酶联免疫吸附试验试剂盒检测白细胞介素(IL)-18 和肿瘤坏死因子(TNF)-α、C 反应蛋白(CRP)、细胞间黏附分子 1(ICAM-1)、血管细胞黏附分子 1(VCAM-1)、E-选择素和 P-选择素等炎症因子。还检测了内中膜厚度(IMT)、肱踝脉搏波速度(Ba-PWV)、呼吸暂停低通气指数(AHI)和经皮血氧饱和度(SpO2),以比较治疗前后的差异。结果显示,与治疗前相比,治疗后 IL-8、TNF-α、CRP、ICAM-1、VCAM-1、E-选择素和 P-选择素的表达水平显著降低(P<0.05)。AHI、IMT、血压和 Ba-PWV 值显著降低(P<0.05),SpO2 升高(P<0.05)。综上所述,通过比较干预前后的数据,证实了炎症因子参与了 OSAS 患者 AS 的发生过程。CPAP 治疗后,患者的血压和主要指标均得到改善。

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