老年阻塞性睡眠呼吸暂停低通气综合征患者血管内皮舒张功能的变化 |
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引用本文: | 丁海波,林其昌,陈玲,陈公平,黄建钗,张宏英. 老年阻塞性睡眠呼吸暂停低通气综合征患者血管内皮舒张功能的变化[J]. 中华老年医学杂志, 2009, 28(7): 705-707. DOI: 10.3760/cma.j.issn.0254-9026.2009.09.001 |
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作者姓名: | 丁海波 林其昌 陈玲 陈公平 黄建钗 张宏英 |
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作者单位: | 福建医科大学附属第一医院呼吸科,福州,350005;福建医科大学附属第一医院B超室,福州,350005; |
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摘 要: | Objective To evaluate the vascular endothelial dilatation function in elderly patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Thirty elderly patients with moderate to severe OSAHS and twenty-eight control subjects were studied. Their blood concentration of nitric oxide (NO) were quantified. Brachial artery diameter was measured with Doppler ultrasound under baseline conditions, during reactive hyperemia (an endothelium-dependent dilatation) and after sublingual administration of nitroglycerin ( an endothelium-independent vasodilator). The dilative rate of brachial artery in different conditions was calculated to evaluate the endothelial function. Subjects with OSAHS were treated by nasal continuous positive airway pressure (nCPAP) for 4 weeks, and the level of NO in plasma and vascular endothelial function were measured. Results Compared with control group, there was a significant decrease of NO level in elderly patients with moderate to severe OSAHS [(50. 35±8.65)μmol/L vs. (57.31±9.31)μmol/L, t=2.95,P=0.005], and the level of NO in plasma was increased after nCPAP treatment for 4 weeks [(55.77±8.87)μmol/L vs. (50.35± 8.65)μmol/L,t=2.40,P=0.023. The elderly patients with moderate to severe OSAHS had lower endothelium-dependent flow-mediated dilation (FMD) compared with control subjects [(9.78± 4.82)%vs. (13.21±5.81)%,t=2.45, P=0.017], and there was no significant difference in endothelium-independent nitroglycerin ( NTG)-induced dilation [( 16.87±6.15)% vs. (14.74 ± 5.82)%,t=1.36,P=0.18]. After nCPAP treatment for 4 weeks, the patients with moderate to severe OSAHS had significant increase in FMD[(14.33±6.13)% vs. (9.78±4.82)%, t=3.20,P= 0.002], whereas there was no significant change in NTG-induced dilation [(14.74±5.82)% vs. (15.15±4.21)%, t=0.31,P=0.76]. Conclusions The elderly patients with moderate to severe OSAHS have abnormal vascular endothelial function, and nCPAP treatment can reverse the dysfunction effectively, which may be associated with the reversal of intermittent hypoxia.
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关 键 词: | 睡眠呼吸暂停,阻塞性 一氧化氮 内皮,血管 血管舒张 |
The research on vascular endothelial dilatation function in elderly patients with obstructive sleep apnea hypopnea syndrome |
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Abstract: |
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Keywords: | Sleep apnea obstructiveNitric oxideEndothelium vascularVasodilation |
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