摘要
目的探讨慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆内皮素-1(ET-1)、一氧化氮(NO)与肺动脉高压的关系。方法选择COPD患者53例,其中合并肺动脉高压患者18例;OSAHS患者50例,其中合并肺动脉高压患者14例和重叠综合征(COPD合并OSAHS,即OS)患者25例,其中合并肺动脉高压患者12例,应用超声心动图评估肺动脉压,放射免疫法测定血浆ET-1水平,硝酸酶还原法测定NO水平,比较3组患者睡眠呼吸暂停严重程度及睡眠时缺氧程度。结果 3组患者睡眠呼吸暂停低通气指数(apneahypopnea index,AHI)、血氧饱和度(SaO2)<90%时间占总睡眠时间百分比(cumulative percentage of sleep time withSaO2below90%,TSaO2<90%)、最低血氧饱和度(MinSaO2)比较,差异均有统计学意义(P<0.01),OS组与COPD组、OSAHS组相比夜间MinSaO2降低(P<0.05)、TSaO2<90%增加,差异均有统计学意义(P<0.05);AHI升高亦有统计学意义(P<0.05)。3组合并肺动脉高压患者NO和ET-1水平比较,差异均有统计学意义(P<0.01)。OS合并肺动脉高压患者较未合并肺动脉高压患者ET-1水平升高,NO水平降低,差异均有统计学意义(P<0.05)。结论 OS患者较单纯的COPD和单纯OSAHS患者夜间缺氧更明显,更易形成肺动脉高压。血浆NO降低、ET-1升高与肺动脉压升高有一定关系。
Objective To explore the relationship of endothelin-1（ET-1） and nitric oxide（NO） to pulmonary arterial pressure（PAP） in chronic obstructive pulmonary disease（COPD） patients with obstructive sleep apnea-hypopnea syndrome（OSAHS）.Methods PAP was evaluated by echocardiography,ET-1 level detected by radioimmunoassay,NO level by nitrate reductase method in 53 COPD patients including 18 complicated by PAP,50 OSAHS including 14 complicated by PAP,25 overlap syndrome（OS） including 12 by PAP.The severity of sleep apnea and hypoxia was analyzed.Results There was significant difference between 3 groups in apnea hypopnea index（AHI）,cumulative percentage of sleep time with SaO2 below 90%（T SaO290%）and MinSaO2（P0.01）.MinSaO2 was lower in OS group than in groups COPD,OSAHS（P0.05）,and T SaO290% higher（P0.05）,AHI higher（P0.05）.There was significant difference in levels of NO and ET-1 between 3 groups（P0.01）.ET-1 level increased,NO decreased in OS patients with PAP as compared with those without PAP,the difference was significant（P0.05）.Conclusion OS patients had more obvious night hypoxia and easier to get PAP as compared with patients with simple COPD or OSAHS.Reduction of plasma NO and increase of ET-1 are related to elevated PAP.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第24期2691-2693,共3页
Chinese General Practice
