Kimura H, Niijima M, Abe Y, Edo H, Sakabe H, Kojima A, Hasako K, Masuyama S, Tatsumi K, Kuriyama T
Department of Chest Medicine, Chiba University School of Medicine.
Intern Med. 1998 Feb;37(2):127-33. doi: 10.2169/internalmedicine.37.127.
Since obstructive sleep apnea syndrome (OSAS) is often linked with systemic hypertension, we sought to clarify the characteristics of prostanoid metabolism in OSAS. In 7 OSAS patients (apnea-hypopnea index, 51.0 +/- 23.4) and 7 non-snorers as control, nocturnal urine was sampled and analyzed for stable metabolites of prostacyclin (PGI2) and thromboxane A2 (TxA2), [6-keto-PGF1alpha and thromboxane B2 (TxB2)]. The ratio of 6-keto-PGF1alpha to TxB2 was significantly higher in OSAS (2.97 +/- 1.52) than in control (1.38 +/- 0.38). Successful treatment with nasal continuous positive airway pressure (8.3 +/- 1.5 cmH2O) for 3 days caused a significant decrease in mean blood pressure in OSAS. Moreover, the 6-keto-PGF1alpha to TxB2 ratio also significantly decreased to 1.74 +/- 0.58, a level which may not significantly different from control. These results suggest that the production ratio of PGI2 to TxA2 is shifted toward vasodilatation in untreated OSAS. We conclude that the production of prostanoids plays a role in compensating for the systemic hypertension in OSAS.
由于阻塞性睡眠呼吸暂停综合征（OSAS）常与系统性高血压相关，我们试图阐明OSAS中前列腺素代谢的特征。在7例OSAS患者（呼吸暂停低通气指数为51.0±23.4）和7例作为对照的非打鼾者中，采集夜间尿液并分析前列环素（PGI2）和血栓素A2（TxA2）的稳定代谢产物，即[6-酮-前列腺素F1α和血栓素B2（TxB2）]。OSAS患者的6-酮-前列腺素F1α与TxB2的比值（2.97±1.52）显著高于对照组（1.38±0.38）。经鼻持续气道正压通气（8.3±1.5 cmH2O）成功治疗3天导致OSAS患者平均血压显著下降。此外，6-酮-前列腺素F1α与TxB2的比值也显著降至1.74±0.58，这一水平可能与对照组无显著差异。这些结果表明，在未经治疗的OSAS中，PGI2与TxA2的生成比例向血管舒张方向偏移。我们得出结论，前列腺素的生成在OSAS系统性高血压的代偿中起作用。
