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目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压患者血清诱导型一氧化氮合成酶(i NOS)浓度变化情况及其相关因素。方法将2012年9—12月中国医科大学呼吸疾病研究所研究纳入的受试者分为单纯OSAHS组、OSAHS合并高血压组及健康对照组,分别对三组受试者血清i NOS浓度进行定量检测,比较各组间血清iNOS浓度并进行相关分析。结果与健康对照组血清iNOS浓度相比[(3.04±0.38)nmol/L],单纯OSAHS组[(3.35±0.37)nmol/L]明显上升(P<0.05),OSAHS合并高血压组升高更为明显[(3.66±0.26)nmol/L,P<0.01)]。相关性分析提示,单纯OSAHS组患者iNOS浓度与呼吸暂停低通气指数、氧饱和度低于90%的时间占监测时间的百分比及最低指端血氧饱和度相关(r值分别为0.43、0.47和-0.43,均P<0.05),而OSAHS合并高血压组患者iNOS浓度与呼吸暂停低通气指数、氧饱和度低于90%的时间占监测时间的百分比及舒张压水平呈正相关(r值分别为0.46、0.46和0.45,均P<0.05)。结论 OSAHS患者血清iNOS浓度较正常组增加,且与疾病严重程度密切相关,当合并高血压时血清iNOS浓度上升更明显,提示OSAHS本身可独立导致iNOS的改变,而iNOS的升高在OSAHS致高血压中可能起一定作用。
Objective To investigate the changes of serum concentration of inducible nitric oxide synthase (iNOS) and its related factors in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and hypertension. Methods The subjects enrolled in the Institute of Respiratory Diseases, China Medical University from September to December in 2012 were divided into two groups: OSAHS alone group, OSAHS combined hypertension group and healthy control group. Serum i NOS concentrations in three groups were quantified The levels of serum iNOS in each group were compared and analyzed. Results Compared with healthy control group, the serum iNOS concentration was significantly higher in OSAHS group ([(3.04 ± 0.38) nmol / L] and OSAHS group (3.35 ± 0.37) nmol / L (3.66 ± 0.26) nmol / L, P <0.01). Correlation analysis showed that the iNOS concentration and apnea hypopnea index in patients with OSAHS alone, the percentage of oxygen saturation less than 90% of the time and the lowest finger oxygen saturation (r = 0.43,0.47 and -0.43, all P <0.05). However, the correlation between iNOS concentration and apnea-hypopnea index, the percentage of oxygen saturation less than 90%, the percentage of monitoring time and the diastolic blood pressure in patients with OSAHS and hypertension (r = 0.46, 0.46 and 0.45, all P <0.05). Conclusions The serum concentration of iNOS in patients with OSAHS is higher than that in the normal group and closely related to the severity of the disease. Serum iNOS concentration rises more obviously in patients with OSAHS, which suggests that OSAHS itself can independently lead to iNOS changes, whereas iNOS rise is higher in patients with OSAHS Blood pressure may play a role.