摘要
目的 探讨阻塞性睡眠呼吸暂停低通气综合征患者血管内皮功能变化指标血浆一氧化氮（NO）及内皮素（ET）与冠心病（CHD）的内在联系。方法 随机选择38例中老年健康者为对照组，46例中老年中、重度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者为OSAHS组，OSAHS组内又分为有CHD（16例）和无CHD（30例）两个亚组。测定和比较组间的血浆一氧化氮（NO）、内皮素（ET）及其比值的动态变化及OSAHS组内CHD有无的区别。结果与对照组相比，OSAHS组患者的NO水平明显降低[（32±13）μmol／LVS（58±13）μmol／L，P〈0.01]，ET水平明显升高[（50±14）ng／LVS（35±7）ng／L，P〈0．05]；NO／ET比值明显下降（0．59±0．34VS1．67±0．62，P〈0．01）。CHD的发生率在OSAHS组达34．8％。与对照组相比，OSAHS组中不伴CHD者降低的NO水平[（40±6）μmol／L]、升高的ET水平[（44±7）ng／L]和下降的NO／ET比值0．91±0.32比较差异有统计学意义（P均〈0.05）。伴有CHD者NO水平[（28±11）μmol／L]、ET水平[（63±10）ng／L]和NO／ET比值（0.44±0．23）与对照组比较差异有统计学意义（P〈0．01）。结论OSAHS中、老年患者存在明显的血管内皮功能障碍，尤CHD者为甚，血管内皮功能损伤可能是OSAHS患者并发CHD的原因。
Objective To investigate the association of functional change index of vascular endothelium, plasma levels of nitricoxide （NO） and endothelium with coronary heart disease （CHD） in patients with obstructive sleep apnea syndrome （OSAHS）. Methods Thirty - eight healthy middle - aged and elderly people were randomly selected as control group. Forty - six middle - aged or elderly patients with moderate or severe degree of OSAHS were recruited as OSAHS group,which were further divided into two subgroups,CHD subgroup （sixteen patients） and non - CHD subgoup （thirty patients）. The changes of plasma contrations of NO and ET were tested and compared between groups. Results Compared with control group,in OSAHS group there was a significant lower NO level [ （32 ± 13） μmol/L vs （58 ±13） μmol/L], P 〈0.01 ,higher ET level [ （50 ±14） ng/L vs （35±7.4） ng/L], P 〈0.05,and lower rate of NO/ET （0.6 ±0.3 vs 1.7 ±0.6, P 〈0.01）.The incidence of CHD in OSAHS group was 34. 8%. Comparison between control group and non - CHD OSAHS subgroup showed that the decreased NO level [ （40 ±6） μmol/L] ,inceased ET level[ （44±7） ng/L] and declined NO/ ET （0. 91±0. 32） in non- CHD group were statistically significant （ P 〈0.05）. Such a difference was more significant between control group and CHD OSAHS subgroup （all P 〈0.01 ）. Conclusion Vascular endothelial function was significantly impaired in patients with OSAHS, especially in those with both OSAHS and CHD. Vascular endothelial dysfunction may be one of the causes of complicated CHD in OSAHS patients.
出处
《中原医刊》
2007年第3期15-17,共3页
Central Plains Medical Journal
