Jiang Yong-Qian, Xue Jin-Shan, Xu Juan, Zhou Zhi-Xiang, Ji You-Lin
Department of Respiratory Medicine, The First People's Hospital of Yancheng, Yancheng, Jiangsu 224006, P.R. China.
Exp Ther Med. 2017 Dec;14(6):6176-6182. doi: 10.3892/etm.2017.5308. Epub 2017 Oct 16.
Sleep apnea negatively impacts patients' ability to oxygenate the bloodstream during sleep and has far-reaching, deleterious effects. The present study sought to assess the correlation between obstructive sleep apnea hypopnea syndrome (OSAHS), carotid atherosclerosis, and blood pressure variability (BPV), and to evaluate the therapeutic effects of continuous positive airway pressure (CPAP). Patients with OSAHS were classified as mild, moderate, or severe according to their condition and compared with healthy control participants. CPAP treatment was used to treat patients with OSAHS for 6 months. Prior to CPAP treatment, the apnea-hypopnea index (AHI), lowest blood oxygen saturation (LSaO), carotid intima media thickness (IMT), and plasma levels of endothelin-1 (ET-1), nitric oxide (NO), and tumor necrosis factor-α (TNF-α) were measured in all participants, along with the low frequency components of BPV (BPV LF). The results demonstrated that carotid IMT, AHI, plasma ET-1, and plasma TNF-α were significantly higher in patients with OSAHS than those in the control group (P<0.05); whereas LSaO and plasma NO levels were significantly higher in the control group (P<0.05). The degree to which these indices differed was associated with the severity of OSAHS. Furthermore, the carotid IMT of patients with OSAHS was significantly correlated with AHI (P=0.037), plasma ET-1 (P=0.001), plasma NO (P<0.001), BPV LF before retiring (P<0.001). Following CPAP treatment, the observation indices of patients with moderate or severe OSAHS improved significantly (P<0.01). These results support the use of CPAP to improve the significant vascular endothelial dysfunction, increased inflammatory response, and high blood pressure variability correlated with carotid atherosclerosis observed in patients with OSAHS.
睡眠呼吸暂停会对患者睡眠期间血液氧合能力产生负面影响,并具有深远的有害影响。本研究旨在评估阻塞性睡眠呼吸暂停低通气综合征(OSAHS)、颈动脉粥样硬化和血压变异性(BPV)之间的相关性,并评估持续气道正压通气(CPAP)的治疗效果。根据病情将OSAHS患者分为轻度、中度或重度,并与健康对照参与者进行比较。使用CPAP治疗OSAHS患者6个月。在CPAP治疗前,测量了所有参与者的呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO)、颈动脉内膜中层厚度(IMT)以及血浆内皮素-1(ET-1)、一氧化氮(NO)和肿瘤坏死因子-α(TNF-α)水平,以及BPV的低频成分(BPV LF)。结果表明,OSAHS患者的颈动脉IMT、AHI、血浆ET-1和血浆TNF-α显著高于对照组(P<0.05);而对照组的LSaO和血浆NO水平显著更高(P<0.05)。这些指标的差异程度与OSAHS的严重程度相关。此外,OSAHS患者的颈动脉IMT与AHI(P=0.037)、血浆ET-1(P=0.001)、血浆NO(P<0.001)、睡前BPV LF(P<0.001)显著相关。CPAP治疗后,中度或重度OSAHS患者的观察指标有显著改善(P<0.01)。这些结果支持使用CPAP来改善OSAHS患者中观察到的与颈动脉粥样硬化相关显著的血管内皮功能障碍、炎症反应增加和高血压变异性。