阻塞型睡眠呼吸暂停低通气综合征患者血管活性肠肽与睡眠质量的关系

为明确阻塞型睡眠呼吸暂停低通气综合征 (OSAHS)患者清醒及不同睡眠期血中血管活性肠肽 (VIP)质量浓度与睡眠质量之间的关系 ,以 1 2例OSAHS患者为研究对象 ,在桡动脉内留置导管监测血压 ,同步进行夜间多导睡眠仪连续记录 ,并分别于睡前清醒时、非快动眼 (NREM)睡眠期、快动眼 (REM )睡眠期及清晨从桡动脉留置的导管内抽取血标本 ,采用放免分析法检测VIP。结果 :1 )睡前清醒时及清晨血VIP质量浓度与总睡眠时间和记录时间之比(TST/TRT ,睡眠效率 )成正相关 (r =0 .5 91 ,P <0 .0 5 ) ,与醒觉时间和记录时间之比 (Arousal/TRT)成负相关 (r =-0 .5 86,P <0 .0 5 ) ;以睡前清醒时作基础值 ,NREM期血VIP质量浓度的变化与快波睡眠和总睡眠时间之比 (Ⅰ +Ⅱ /TST)成负相关 (r=-0 .65 6,P <0 .0 5 ) ,与快动眼睡眠时间和总睡眠时间之比 (REM/TST)成正相关 (r =0 .70 5 ,P <0 .0 1 ) ,REM期血VIP质量浓度的变化与REM/TST成正相关 (r=0 .60 9,P <0 .0 5 ) ;2 )OSAHS患者清醒与不同睡眠期血中VIP质量浓度与最长呼吸暂停时间和睡眠呼吸暂停指数 (AHI)成正相关 ,与血氧的有关指标无相关性。提示 :VIP可能参与OSAHS患者睡眠的调节

Relationship between Vasoactive Intestinal Peptide and Sleep Quality in Patients with Obstructive Sleep Apnea-hypopnea Syndrome

The aim was to determine the relationship between plasma concentrations of Vasoactive intestinal peptide (VIP) and sleep quality in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Retaining manometric tube in radial artery and polysomnography (PSG) were done synchronously in 12 patients with OSAHS who was diagnosed by whole-night PSG. Blood specimen were extracted before sleep, during NREM sleep and REM sleep and the next morning to detect plasma concentrations of VIP with Radioimmunoassay(RIA) method. Results: 1) The VIP values before sleep and in the morning were positively correlated with sleep efficacy(the ratio of total sleep time to total record time, r=0.591,P<0.05) and negatively with Arousal/TRT(the ratio of time in arousal to total sleep time, r=-0.586,P<0.05);The VIP values before sleep were regarded as baseline, the changes in VIP values in NREM sleep were negatively correlated with the ratio of time in stageⅠ+Ⅱto total sleep time(Ⅰ+Ⅱ/TST,r=-0.656,P<0.05) and positively correlated with the ratio of time in REM sleep to total sleep time(REM/TST,r=0.705,P<0.01) and those in REM sleep were also positively correlated with REM/TST(r=0.609,P<0.05); 2) The VIP values in different period were positively correlated with the longest time of sleep apnea and apnea-hypopnea index(AHI), but not with hypoxia. In conclusion, VIP may be involved in regulating the sleep in patients with OSAHS.