老年人阻塞性睡眠呼吸暂停综合征与血管内皮功能变化及冠心病的关系

目的 探讨老年人阻塞性睡眠呼吸暂停综合征（OSAS）与血管内皮功能变化及冠心病（CUD）的内在联系。方法 通过使用多导睡眠仪对24例单纯OSAS老年患者、30例OSAS并发冠心痛老年患者及10例健康老人进行氧减饱和指数（ODI）和睡眠呼吸暂停指数（AHI）监测分析，测定和比较组间的血浆一氧化氮（NO）、内皮素（ET）及比值的动态变化。结果 OSAS合并冠心痛组枷及ODI显著高于单纯OSAS组及对照组（P〈0．01），该组有更低的血氧饱和度（P〈0．01），与对照纽比较，OSAS纽的NO水平降低、ET水平升高、NO／ET比值下降（P〈0．05），伴有CHD者的NO水平、ET水平及NO／ET比值较对照组相差更为明显（P〈0．01）。结论 OSAS老年患者存在明显血管内皮功能障碍，合并冠心病时更明显，与严重的夜间低氧血症有关，血管内皮功能损伤可能是OSAS患者并发冠心病的原因之一。

Association between functional changes in vascular endothelium and coronary heart disease in elderly patients with obstructive sleep apnea syndrome

Objective To investigate the association between functional changes in vascular endothelium and coronary heart disease(CHD) in elderly patients with obstructive sleep apnea syndrome(OSAS).Methods This study monitored 24 patients with simple OSAS and 30 OSAS patients complicated with coronary heart disease and 10 healthy elderly people by analyzing their oxygen desaturation index(ODI) and apnea / hypopnea index(AHI);The changes in plasma concentrations of nitric oxide(NO) and endothelin (ET) and NO/ET were tested and compared among groups.Results AHI and ODI of the patients complicated with coronary heart disease was greater than that of the simple OSAS and control group (P<0.01),and they had lower minimal arteral oxyhemoglobin saturation(P<0.01) during sleep;Compared with control group,there was a significant lower NO level,higher ET level and lower NO/ET in OSAS subgroups(P<0.05).Such a difference was especially significant between control group and OSAS with CHD subgroup(P<0.01).Conclusions Vascular endothelial function is significantly impaired in elderly patients with OSAS,especially in those with both OSAS and CHD,which is associated with sever nocturnal arterial blood oxyhemoglobin desaturation.Vascular endothelial dysfunction may be one of the causes of elderly OSAS patientsbeing comlicatec with CHD.