Pokala P, Llanera M, Sherwood J, Scharf S, Steinberg H
Division of Pulmonary and Critical Care Medicine, Long Island Jewish Medical Center, New Hyde Park, NY 11040, USA.
Am J Respir Crit Care Med. 1995 Jun;151(6):1862-5. doi: 10.1164/ajrccm.151.6.7767532.
We measured nocturnal plasma erythropoietin concentration (EPO) in eight subjects with obstructive sleep apnea syndrome (OSAS) and eight healthy overweight subjects while they were undergoing nocturnal polysomnography. We also measured EPO (radioimmunoassay) after 120 min of exposure to 10.5% O2. The subjects with OSAS had a respiratory disturbance index (RDI) of 50.8 +/- 41.9 and a maximal O2 desaturation of 65 +/- 13.3%, and they spent 104.5 +/- 89.3 min out of a total sleep time of 356 +/- 54 min below 90% oxygen saturation (T90). Nocturnal EPO concentrations were normal and did not differ between the two groups. We found no correlation between the T90, T80, or RDI and either the mean or maximal EPO concentrations. After the exposure to 10.5% oxygen, during which oxygen saturations were between 80 and 85%, the healthy subjects and those with OSAS developed increases in EPO of 34 and 49%, respectively, 240 min after the initiation of exposure (p < 0.05). We conclude that the nocturnal hypoxemia occurring in these subjects with OSAS may not have been sufficiently severe to stimulate an increased EPO production. The lack of EPO response was not due to down-regulation of EPO production.
我们在8名阻塞性睡眠呼吸暂停综合征（OSAS）患者和8名健康超重受试者进行夜间多导睡眠图检查时，测量了他们夜间血浆促红细胞生成素浓度（EPO）。我们还在让受试者暴露于10.5%氧气环境120分钟后测量了EPO（放射免疫测定法）。OSAS患者的呼吸紊乱指数（RDI）为50.8±41.9，最大氧饱和度下降为65±13.3%，在总睡眠时间356±54分钟中，他们有104.5±89.3分钟的氧饱和度低于90%（T90）。夜间EPO浓度正常，两组之间无差异。我们发现T90、T80或RDI与平均或最大EPO浓度之间均无相关性。在暴露于10.5%氧气期间，此时氧饱和度在80%至85%之间，健康受试者和OSAS患者在开始暴露240分钟后EPO分别升高了34%和49%（p<0.05）。我们得出结论，这些OSAS患者出现的夜间低氧血症可能不够严重，不足以刺激EPO生成增加。EPO缺乏反应并非由于EPO生成的下调。
