【摘要】 目的:探讨阻塞性睡眠呼吸暂停综合征(OSAHS)患者炎症因子的水平与合并高血压的相关性。方法:根据24h动态血压和多导睡眠图(PSG)监测结果将84例受检者分为正常对照组(n=22)、单纯高血压组(HT组,n=31)和中重度OSAHS合并高血压组(OSAHS+HT组,n=31)。OSAHS诊断根据PSG监测结果,血压监测采用24h动态血压监测仪,以酶联免疫吸附法测定白细胞介素18(IL-18)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)及血管细胞黏附分子1(VCAM-1)的浓度。结果:①OSAHS+HT组中非杓型血压的发生率为62%,明显高于HT组的31%(P<0.05)。②OSAHS+HT组24h、白天、夜间平均脉压[分别为(50.5±11.8)mmHg(1mmHg=0.133kPa)、(51.4±10.9)mmHg、(52.2±15.8)mmHg]明显高于HT组[分别为(45.9±6.9)mmHg、(48.1±8.1)mmHg、(43.9±6.7)mmHg](均P<0.05)。③OSAHS+HT组的IL-18、hs-CRP、TNF-α、VCAM-1浓度明显高于HT组和正常对照组;HT组的IL-18、hs-CRP、TNF-α、VCAM-1浓度明显高于正常对照组(均P<0.05)。④OSAHS+HT组的hs-CRP和VCAM-1浓度变化与呼吸紊乱指数、氧减饱和度呈正相关(P<0.01)。结论:中重度OSAHS患者存在明显炎症反应,可能与其血压昼夜节律及脉压的变化相关。更多还原

【Abstract】 Objective To investigate the correlation between inflammatory factors and hypertension in patients with moderate/severe obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Eighty-four persons were divided into healthy group (n=22),hypertension group (HT group,n=31),and moderate/severe OSAHS with hypertension group (OSAHS+HT group,n=31) according to the results of examination of polysomnography and blood pressure (BP) measured by 24 h ambulatory blood pressure monitoring (ABPM). Serum levels of interleukin (IL)-18,high sensitivity C-reactive protein(hs-CRP),tumor necrosis factor(TNF)-α,vascular cell adhesion molecule 1(VCAM -1) were measured by enzyme linked immunosorbent assay (ELISA). Results ①The rate of non-dipper profile of blood pressure in OSAHS+HT group (60%) was significantly higher than that in HT group (31%). ② Twenty-four hours,daytime,nighttime mean pulse pressure in OSAHS +HT group[(50.5±11.8) mm Hg (1 mm Hg = 0.133 kPa),(51.4±10.9) mm Hg,(52.2±15.8) mm Hg,respectively] was significantly higher than that in hypertension group [(45.9±6.9) mm Hg,(48.1±8.1) mm Hg,(43.9±6.7) mm Hg,respectively](all P<0.05). ③ Serum levels of IL-18,hs-CRP,TNF-α,and VCAM -1 were significantly higher in OSAHS+ HT group than that in both the hypertension group and healthy group (all P <0.05),and also statistically higher in hypertension group than in healthy group. ④ In OSAHS + HT group,serum levels of hs-CRP and VCAM-1 were positively correlated with apnea-hypopnea index (AHI)and O2 desaturation (all P<0.01). Conclusions Remarkable inflammatory reaction existed in patients with moderate /severe OSAHS and might be correlated with the changes of the circadian rhythm of blood pressure variability and pulse pressure.更多还原