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目的测定阻塞性睡眠呼吸暂停低通气综合征(OSAHS)并肺动脉高压(pH)患者血浆一氧化碳(CO)、肾上腺髓质素(adrenomedullin,ADM)水平,分析其在pH发生发展中的作用。方法选2002年3月至2004年10月在郑州大学第一附属医院经多导睡眠仪监测诊断的58例OSAHS患者,分为单纯OSAHS组、OSAHS并pH组,选取30名健康体检者为正常对照组。检测各组血浆CO、ADM水平、RVPEP/AT、AHI、minSaO2及TSaO2水平,并进行相关性分析。结果单纯OSAHS组及OSAHS并pH组血浆内源性CO、ADM水平[CO:(1.04±0.16)mg/L,ADM:ADM:(54.19±11.60)pg/ml;CO:(1.35±0.13)mg/L,ADM:ADM:(79.82±15.33)pg/ml]均高于正常对照组[CO:(0.51±0.16)mg/L,ADM:(44.73±8.52)pg/ml,P<0.01];OSAHS并pH组又高于单纯OSAHS组(P<0.01)。经nCPAP治疗后OSAHS并pH患者血浆CO、ADM水平明显降低[CO:(1.35±0.13)mg/L,ADM:(79.82±15.33)pg/ml;CO:(1.16±0.11)mg/L,ADM:(63.48±10.76)pg/mlP<0.01],血浆CO、ADM水平与RVPEP/AT、AHI、TSaO2呈正相关,与minSaO2呈负相关。结论CO、ADM共同参与了OSAHS患者pH的发生发展过程。
Objective To determine the levels of plasma CO and adrenomedullin (ADM) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and pulmonary hypertension (pH) and analyze their role in the development of pH. Methods Fifty-eight OSAHS patients diagnosed by polysomnography in the First Affiliated Hospital of Zhengzhou University from March 2002 to October 2004 were divided into OSAHS group and OSAHS group, and 30 healthy subjects were selected as normal Control group. Plasma CO, ADM levels, RVPEP / AT, AHI, minSaO2 and TSaO2 levels in each group were measured and the correlation analysis was performed. Results The levels of endogenous CO and ADM in OSAHS group and OSAHS group were significantly higher than those in OSAHS group ([CO]: 1.04 ± 0.16 mg / L, ADM: ADM /L,ADM:ADM:(79.82 ± 15.33pg / ml] were higher than those in the normal control group [CO: (0.51 ± 0.16) mg / L, ADM: (44.73 ± 8.52) pg / ml, P <0.01] OSAHS and pH group was higher than OSAHS group (P <0.01). The levels of plasma CO and ADM in patients with OSAHS and pH after nCPAP treatment were significantly lower than those in patients without OSA [CO: 1.35 ± 0.13 mg / L, ADM: 79.82 ± 15.33 pg / ml, CO: 1.16 ± 0.11 mg / : (63.48 ± 10.76) pg / ml P <0.01]. Plasma CO and ADM levels were positively correlated with RVPEP / AT, AHI, TSaO2 and negatively correlated with minSaO2. Conclusion CO and ADM participate in the development of pH in patients with OSAHS.