摘要
目的观察阻塞性睡眠呼吸暂停综合征患者(OSAHS)血清非对称二甲基精氨酸(ADMA)和一氧化氮(NO)的变化。方法选取医院2015年1月-2016年12月收治的OSAHS患者75例作为观察组,根据患者呼吸暂停通气指数(AHI)及血氧饱和度(SaO_(2min)),分为轻度组25例,中度组27例和重度组23例,另选同期健康体检者30例为健康组,采用酶联免疫吸附法(ELISA)检测血清ADMA水平,硝酸还原酶比色法检测血清NO水平,行相关性分析,将观察组中度、重度组患者50例分为治疗亚组34例和对照亚组16例,治疗亚组需经鼻持续气道正压通气(nCPAP)治疗。对照亚组患者16例,未接受针nCPAP治疗。结果血清ADMA水平随OSAHS病情加重而升高,以重度OSAHS组最高;血清NO水平随OSAHS病情加重而降低,以重度OSAHS组最低。血清ADMA水平与t_(SaO2<90%)呈正相关,与SaO_(2mean)、SaO_(2min)呈负相关;血清NO水平与t_(SaO2<90%)呈负相关,与SaO_(2mean)、SaO_(2min)呈正相关。随访2个月,无失访患者,治疗前治疗亚组及对照亚组PSG参数及血清ADMA、NO水平比较差异均无统计学意义(P> 0.05),治疗后,治疗亚组PSG参数及血清ADMA水平、NO水平均较治疗前及对照亚组改善,差异有统计学意义(P<0.05);对照亚组PSG参数及血清ADMA、NO水平与治疗前比较差异无统计学意义(P> 0.05)。结论 OSAHS患者血清ADMA水平明显升高,NO水平下降,有效n CPAP治疗可使ADMA水平下降,升高NO水平。
Objective To analyze the changes of serum asymmetric dimethylarginine（ADMA） and nitric oxide（NO）in patients with obstructive sleep apnea-hypopnea syndrome（OSAHS）.Methods 75 OSAHS patients admitted to the hospital from January 2015 to December 2016 were selected as observation group.According to the apnea ventilation index（AHI） and oxygen saturation（SaO2 min）,the patients were divided into 25 patients in mild group,23 in moderate group and 23 in severe group.Another 30 healthy people in the same period were selected as healthy group.The serum ADMA levels were measured by enzyme-linked immunosorbent assay（ELISA）,and serum nitric oxide（NO） levels were determined by nitrate reductase colorimetric assay.Correlation analysis was performed.In observation group,50 patients in moderate and severe group were divided into treatment group 34 cases and control group 16 cases.nasal continuous positive airway pressure（n CPAP） was needed in treatment group.Control group were not treated with needle n CPAP.Results The plasma ADMA level increased with severity of patient＇s condition and tipped in severe group,while plasma NO level decreased with severity of patient＇ s condition and reached its lowest vlaue in severe group.There was positive correlation between plasma ADMA and t SaO2〈90%,negative correlation between plasma ADMA and SaO2 mean and SaO2 min.There was negative correlation between serum NO and t SaO2〈90%,positive correlation between serum NO and SaO2 mean and SaO2 min.After 2 months of follow-up,no patients were lost to follow-up.There were no significant differences in PSG parameters and serum ADMA and NO levels between treatment group and control group before treatment（P〉0.05）.After treatment,the PSG parameters and serum ADMA levels and NO levels in treatment group improved compared with those before treatment and control group,the difference was statistically significant（P〈0.05）; In control group,there was no significant difference in PSG parameters and serum ADMA and NO levels before and after treatment（P〉0.05）.Conclusion The serum ADMA levels increases significantly in OSAHS patients,and NO levels decreas.Effective n CPAP treatment decreas ADMA levels and increas NO levels.
作者
田雨
李杨
黄成
李翎
贺洪军
沈小钦
陈艳
杨文强
TIAN Yu;LI Yang;HUANG Cheng(Department of Respiratory Medicine,The People＇s Hospital of Anyue,Sichuan Province,Anyue 642350,China)
出处
《临床合理用药杂志》
2018年第28期15-16,19,共3页
Chinese Journal of Clinical Rational Drug Use
