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目的分析OSAHS合并高血压血管内皮功能与交感神经活性的作用。方法打鼾患者115例依照血压测定、多导睡眠检测情况分为单纯OSAHS组(O组,39例),单纯高血压组(H组,35例),OSAHA合并高高血压组(OH组,41例),另外选本院同期健康体检人员无打鼾者50例作为对照组,测定睡眠前后患者血压、交感神经活性及血管内皮因子。结果O、OH组minSaO_2均显著低于对照组(P<0.05),AHI显著高于H组和对照组(P<0.05)。H、OH组睡前血压均显著高于对照组和O组(P<0.05)。O、OH组睡眠NE水平显著高于睡眠前(P<0.05)。醒后O、OH组内皮素均升高,NO下降,对照组和H组醒后内皮素下降,NO升高。O组NE与MDA正相关,醒后MAP与AHI、氧减指数、T90正相关,与minSaO_2负相关。NE与睡眠呼吸紊乱负相关,OH组内皮素与NP负相关。结论 OSAHS病情与交感神经活性增强有关。
Objective To analyze the role of OSAHS in the vascular endothelial function and sympathetic nerve activity in patients with hypertension. Methods One hundred and fifteen patients with snoring were divided into OSAHS group (n = 39), Hypertension group (n = 35) and OSAHA group (OH group, 41 In addition, 50 healthy non-snorers in the same period of our hospital were selected as the control group. Blood pressure, sympathetic nerve activity and vascular endothelial factor were measured before and after sleep. Results The levels of minSaO_2 in O and OH groups were significantly lower than those in control group (P <0.05), and AHI was significantly higher than that in H group and control group (P <0.05). H, OH group before bedtime blood pressure were significantly higher than the control group and O group (P <0.05). O, OH group sleep NE levels were significantly higher than before sleep (P <0.05). End of wake up O, OH group, endothelin were increased, NO decreased, control group and H group, wake of endothelin decreased, NO increased. There was a positive correlation between NE and MDA in O group. After awakening, MAP was positively correlated with AHI, oxygen reduction index and T90, but negatively correlated with minSaO_2. NE was negatively correlated with sleep-disordered breathing, while endothelin in OH group was negatively correlated with NP. Conclusion OSAHS is associated with increased sympathetic nerve activity.