摘要
目的 探讨阻塞性睡眠呼吸暂停综合征 (OSAS)与左心功能不全的关系 ,及阻塞性睡眠呼吸暂停对血浆内皮素 (ET)、降钙素基因相关肽 (CGRP)的影响。方法 16例未能明确病因的左心衰患者行全夜睡眠监测及 16例经多导睡眠图确诊的单纯 OSAS患者 ,16名健康正常人应用放免法测定血浆内皮素 (ET)和降钙素基因相关肽 (CGRP)。结果 1左心衰合并 OSAS组打鼾年限 2 6 .4a± 11.0 a,明显长于单纯 OSAS组 16 .2 a± 8.7a(P<0 .0 5 ) ,且呼吸紊乱指数(AHI) 39.0 7± 2 1.2、最长呼吸暂停时间 (L AT) 6 1.0 2 s± 12 .0 s明显高于单纯 OSAS组 AHI2 1.11± 10 .2 3、L AT49.41s± 11.2 s(P<0 .0 5 )。 2左心衰合并 OSAS组血浆 ET12 6 .5 7pg/ml± 5 5 .99pg/ml,CGRP315 .5 2 pg/ml± 15 7.18pg/ml明显高于单纯 OSAS组 ET73.77pg/ml± 9.2 0 pg/ml、CGRP6 3.35 pg/ml± 5 3.95 pg/ml(P<0 .0 5 ) ,单纯 OSAS组血浆 ET明显高于健康对照 ET5 3.14pg/ml± 6 .2 3pg/ml(P<0 .0 0 1) ,OSAS组血浆 CGRP水平与健康对照组无显著差异 (P>0 .0 5 )。 3打鼾年限与各组 AHI正相关 (r=0 .795 ,P<0 .0 5 ) ;AHI、L AT与血浆 ET正相关 (r=0 .5 8～ 0 .6 1,P<0 .0 5 )。结论 OSAS患者随病程的延长、病情的加重 ,可以导致左心衰 ;
Objective To observe the change of respiratory disorder status in the sleep,and the plasma endothelin(ET) and calcitonin gene related peptide(CGRP)level in the Obstructive Sleep Apnea Syndrome(OSAS) patients with or without left heart failure.Methods 16 cases of left heart failure underwent full night polysomnography(PSG),16 cases of OSAS patients diagnosed by PSG and 16 cases of healthy volunteer were measured the plasma endothelin and calcitonin generelated peptide level by radioimmunoassay.Results ①The duration of the snoring years in OSAS with left heart failure group(26.4±11.0 years) is significantly higher than that in OSAS group(16.2±8.7 years)(P<0.05).Apnea hypopnea index(AHI) and longest apnea time(LAT) in OSAS with left heart failure group were 39.07±21.2 and 61.02±12.0, which were significantly higher than that in the OSAS group(21.11±10.23 and 35.41±11.2 respectively)(P<0.05).AHI and LAT in OSAS with or without left heart failure group were both significantly higher than that in hearth volunteers group(AHI 1.5±1.2,LAT 10.9±9.8 respectively)(P<0.001).②The plasma endothelin and CGRP level in the OSAS with left heart failure group was 126.57 pg/ml±55.99 pg/ml and 315.52 pg/ml± 157.18 pg/ml, which was significantly higher than that in the OSAS group(73.77 pg/ml±9.20 pg/ml and 63.53 pg/ml±53.95 pg/ml respectively),(P<0.05).The plasma endothelin level in the above groups were significantly higher than that in hearth volunteers group(53.14 pg/ml±6.23 pg/ml)(P<0.001).The plasma CGRP level in OSAS group had no significant differences with the control group(P>0.05).③ The duration of the snoring years had positive correlation with the AHI in all groups(r=0.795,P<0.05);AHI,LAT had positive correlation with the plasma endothelin level(r=0.58～0.61,P<0.05).Conclusion Obstructive sleep apnea might cause left heart failure according to prolonged course and aggravated state of disease;Periodic hypoxia at night and neuro-endocrine abnormal in OSAS can increase plasma endothelin level,that may be one of the essential mechanism that obstructive sleep apnea result in left heart failure.
出处
《中国误诊学杂志》
CAS
2001年第9期1283-1286,共4页
Chinese Journal of Misdiagnostics
