低通气综合征患者血浆食欲素A水平及代谢紊乱的影响

目的评价经鼻持续气道内正压通气（nCPAP）对阻塞性睡眠呼吸暂停低通气综合征（OS-AHS）患者食欲素A（orexin-A）及代谢紊乱的影响。方法测定23例OSAHS患者在nCPAP治疗前及治疗12个月血浆食欲素A水平及部分代谢参数的变化。结果治疗12个月患者血浆食欲素A水平、ESS评分、微觉醒指数（MAI）、血胆固醇（Ch01）、甘油三酯（TG）均较治疗前明显降低，高密度脂蛋白（HDL）升高，差异有统计学意义（P均为〈0．05）；治疗前后体质量指数（BMI）无明显改变（P〉0．05）；OSAHS患者血浆食欲素A水平与AHI及MAI呈正相关（r=0．542，0．671，P〈0．05），与夜间最低血氧饱和度（LS02）呈负相关（r=0．611，P〈0．05），与BMI无相关性（r=0．311，P〉0．05）。结论OSAHS患者血浆食欲素A水平升高，并与病情严重程度相关；长期nCPAP治疗能改善血浆食欲素A水平及脂质代谢紊乱。

Effects of nasal continuous positive airway pressure on plasma orexin-A concentration and the metabolic parameters in obstructive sleep apnea hypopnea syndrome

Objective To evaluate the effects of nasal continuous positive airway pressure(nCPAP)on plasma orexin-A level and the metabolic parameters in patients with obstructive sleep apnea hypopnea syndrome.Methods 23 Patients whose plasma orexin-A levels and the metabolic parameters were reexamined before therapy and after 12 months nCPAP therapy.Results The plasma orexin-A levels in the OSAHS group were significantly higher than those in the control group.After 12 months of nCPAP therapy,the plasma orexin-A levels were decreased,and the metabolic parameters were improved.Conclusion OSAHS may cause the increase of the plasma orexin-A level and metabolic disturbance.The correction of sleep disordered breathing by 12 months nCPAP treatment can reduce the plasma orexin-A level,and can improve metabolic disturbance.