摘要
目的:探究瘦素水平与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)伴勃起功能障碍(ED)患者血管内皮损伤的相关性及持续气道正压通气(CPAP)治疗OSAHS伴ED的效果。方法:选取2021年12月至2023年1月杭州市萧山区第一人民医院收治的99例OSAHS患者为研究对象,将其中将52例伴ED且伴血管内皮损伤的患者分为OSAHS伴ED组,47例不伴有ED与血管内皮损伤患者分为OSAHS不伴ED组,同时另选48例健康者分为对照组。比较三组研究对象基本资料和实验室指标,通过Pearson分析在OSAHS伴ED患者组中瘦素水平与OSAHS伴ED危险因素的相关性,之后采用CPAP治疗OSAHS伴ED组患者,并比较治疗前后OSAHS伴ED组相关指标。结果:三组研究对象年龄、受教育年限比较,差异均无统计学意义(P>0.05);OSAHS伴ED组患者体质量指数(BMI)、Epworth嗜睡量表(ESS)评分、微觉醒指数、呼吸暂停低通气指数(AHI)、一氧化氮合成酶(NOS)、内皮素-1(ET-1)、前列腺素(PGI2)、血栓素(TXA-2)、瘦素水平均高于对照组,最低血氧饱和度(LSaO2)、国际勃起功能指数问卷表-5(IIEF-5)评分、一氧化氮(NO)水平均低于对照组,且BMI、瘦素、NOS、ET-1、PGI2、TXA-2水平均高于OSAHS不伴ED组,IIEF-5评分、NO水平均低于OSAHS不伴ED组,同时OSAHS不伴ED组患者ESS评分、微觉醒指数、AHI均高于对照组,LSaO2低于对照组,上述差异均具有统计学意义(P<0.05);经Pearson分析,在OSAHS伴ED组患者中,瘦素水平与BMI、ESS评分、IIEF-5评分、NO、NOS、ET-1、PGI2、TXA-2均有明显相关性(P<0.05);治疗3、6、12个月后,OSAHS伴ED组患者BMI、AHI、微觉醒指数、瘦素、NOS、ET-1、PGI2、TXA-2水平均低于治疗前,IIEF-5评分、NO水平均高于治疗前,差异均具有统计学意义(P<0.05)。结论:肥胖可加重OSAHS伴ED患者的血管内皮损伤,而CPAP治疗对性功能、肥胖和血管内皮损伤具有改善作用。
Objective To explore the correlation between leptin levels and vascular endothelial injury in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS)with sexual dysfunction(ED)and the effect of continuous positive airway pressure(CPAP).Methods A total of 99 patients with OSAHS admitted to The First People's Hospital of Xiaoshan District from December 2021 to January 2023 were selected as the research subjects.Among them,52 patients with ED were divided into the OSAHS complicated with ED group,47 patients without ED were divided into the OSAHS without ED group,and another 48 healthy individuals were selected as the control group.The basic data and laboratory indicators of the three groups were compared.The correlation between leptin levels and ED risk factors in the OSAHS complicated with ED group was analyzed by Pearson analysis.Then,CPAP was used to treat the OSAHS complicated with ED group,and related indicators before and after treatment were compared.Results There was no statistically significant difference in gender,age,and years of education among the three groups(P>0.05).The body mass index(BMI),Epworth sleepiness scale(ESS)score,microarousal index,apnea-hypopnea index(AHI),the levels of nitric oxide synthase(NOS),endothelin-1(ET-1),prostacyclin(PGI2),thromboxane A2(TXA2),and leptin in the OSAHS complicated with ED group were higher than those in the control group,while the lowest blood oxygen saturation(LSaO2),International Index of Erectile Function-5(IIEF-5)score,and nitric oxide(NO)level were lower than those in the control group.Moreover,the BMI,the levels of leptin,NOS,ET-1,PGI2,and TXA2 in the OSAHS complicated with ED group were higher than those in the OSAHS without ED group,and the IIEF-5 score and NO level were lower than those in the OSAHS without ED group.Meanwhile,the ESS score,microarousal index,and AHI in the OSAHS without ED group were higher than those in the control group,and the LSaO2 was lower than that in the control group.The differences were statistically significant(P<0.05).Through Pearson analysis,there was a significant correlation between leptin level and IIEF-5 score,NO,NOS,ET-1,PGI2,and TXA2 in the OSAHS complicated with ED group,and the differences were statistically significant(P<0.05).After 3,6,and 12 months of treatment,the BMI,AHI,microarousal index,the levels of leptin,NOS,ET-1,PGI2,and TXA2 in the OSAHS complicated with ED group were lower than those before treatment,while the IIEF-5 score and NO level were higher than those before treatment,and the differences were statistically significant(P<0.05).Conclusion Obesity can aggravate vascular endothelial injury in patients with OSAHS complicated with ED,and CPAP treatment can improve sexual function,obesity,and vascular endothelial injury.
作者
郑艳文
邬海燕
胡立红
于秀文
ZHENG Yanwen;WU Haiyan;HU Lihong;YU Xiuwen(Department of Respiratory Medicine,The First People's Hospital of Xiaoshan District,Zhejiang Hangzhou 311200)
出处
《深圳中西医结合杂志》
2025年第10期15-19,共5页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
基金
浙江省中医药科学研究基金项目(2020ZB203)
萧山区重大科技计划项目(2021304)。
关键词
阻塞性睡眠呼吸暂停低通气综合征
勃起功能障碍
肥胖
血管内皮损伤
持续气道正压通气
性功能
Obstructive sleep apnea-hypopnea syndrome
Erectile dysfunction
Obesity
Vascular endothelial injury
Continuous positive airway pressure
Sexual function
