摘要
背景阻塞性睡眠呼吸暂停综合征(OSAS)是一种常见病,其患高血压的发病率远高于无高血压的人群。目的旨在通过检测炎症因子的变化探究(OSAS 导致高血压发生发展的机制。方法根据睡眠呼吸暂停低通气指数(AHI,<5次/h 为无呼吸暂停)将136例入选者共分为5组。①高血压+轻度 OSAS 组:22例,AHI 5～20次/h;②高血压+中重度 OSAS 组:58例,AHI>20次/h;③高血压组:20例,为高血压不合并 OSAS 患者;④OSAS组:16例,为中重度 OSAS 不合并高血压患者,AHI>20次/h;⑤正常对照组:20例,为没有高血压和 OSAS 的健康人。用酶联免疫吸附法(ELISA)测定白介素6(IL-6)、血清可溶性 CD40配体(sCD40L)、高敏 C 反应蛋白(hsCRP)、可溶性胞间黏附分子1(sI(CAM-1)及血管细胞黏附分子(VCAM-1)的浓度。结果①单独 OSAS 组和单独高血压组的 IL-6、sCD40L、hsCRP、sICAM-1、VCAM-1浓度高于正常对照组,(P<0.05);②高血压+OSAS 组的 IL-6、sCD40L、hsCRP、sICAM-1、VACM-1浓度明显高于单独 OSAS 组、单独高血压组和正常对照组;③高血压+OSAS组的 hsCRP、sICAM-1、VCAM-1浓度变化与呼吸紊乱指数、血氧饱和度下降程度正相关;④hsCRP 与平均动脉压正相关。结论炎症反应参与高血压的发生发展,OSAS 可能是通过炎症反应而促发高血压。
Background Obstructive sleep apnea syndrome（OSAS） is a common disease. Prevalence rate of hypertention among patients of OSAS is higher than that without OSAS. Objective To test the hypothesis that inflammatory factors are involved in the pathogenesis of OSAS with hypertension. Methods Based on aspea index （AHI）, 136 subjects were straitified into five groups： （1） OSAS （AHI 5-20 beats/h） with hypertension group（n= 22） ; （2） moderate and severe OSAS with hypertension group（n = 58） ： OSAS （AHI〉20 beats/h） with hypertension; （3） hypertension alone group（n = 20） ; （4） OSAS alone group（ n= 16 ） ： moderate and severe OSAS （ AHI〉 20 beats/ h）; （5） normal control group（n= 20 ）： healthy person without OSAS or hypertension. The serum level of IL-6, sCD40L, hsCRP, sICAM-1, VACM-1 are determined by ELISA method. Results The serum level of IL-6, sCD40L, hsCRP, sICAM-1, VCAM-1 in patients of OSAS alone group or HT alone group is higher than that of normal control group ;whereas, the serum level of IL-6, sCD40L, hsCRP, sICAM-1, VCAM-1 in patients with hypertension co-existed OSAS are furthermore higher than that of OSAS alone group, hypertension alone group （P〈0.05） ;The serum level of hsCRP, sICAM-1, VCAM-1 are positively related with AH1 and decreased SaO2 （r= 0. 852, P〈0.01）. Conclusion Inflammatory factors were associated with pathogenesis of hypertension in patients of obstructive sleep apnea syndrome. OSAS potentially aggravate hypertension via infammatory reaction.
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2008年第10期899-902,共4页
Chinese Journal of Hypertension
