老年阻塞性睡眠呼吸暂停综合征并存脑卒中患者氧化应激指标观察及发病机制探讨

目的 观察老年阻塞性睡眠呼吸暂停综合征(OSAS)合并脑卒中患者血浆中血管内皮生长因子、一氧化氮、内皮素等指标的变化情况并初步探讨其发病机制.方法 经手握式脉搏血氧监测仪监测后,将患者分为OSAS并存脑卒中患者32例;单纯OSAS患者36例;单纯脑卒中患者31例;无脑卒中和OSAS患者33例为对照组.检测血浆中血管内皮生长因子(VEGF)、内皮素(ET)和一氧化氮(NO)浓度.结果 (1)血浆VEGF浓度从高到低分别为:OSAS并存脑卒中患者(195.3±56.7)ng/L、单纯OSAS患者(162.3±48.7)ng/L、单纯脑卒中患者(156.4±51.8)ng/L及正常对照组(114.1±54.Z)ng/L,差异有统计学意义(F=21.02,P<0.05);(2)血浆NO浓度从低到高分别为:OSAS并存脑卒中患者(62.3±4.9)mmol/L、单纯脑卒中患者(64.7±5.1)mmol/L、单纯OSAS患者(66.2±4.2)mmol/L及正常对照组(77.5±6.8)mmol/L,差异有统计学意义(F=17.35,P<0.05);(3)血浆ET浓度从高到低分别为:OSAS并存脑卒中患者(59.8±9.6)ng/L、单纯脑卒中患者(56.5±4.3)ng/L,单纯OSAS患者(54.7±7.9)ng/L、及正常对照组(37.2±8.5)ng/L,差异有统计学意义(F=4.27.P<0.05).结论 (1)OSAS患者血浆VEGF、ET浓度升高,血浆NO水平下降;(2)并存脑卒中的OSAS患者比无脑卒中的单纯OSAS患者血浆VEGF、ET浓度升高更显著,血浆NO水平下降更明显.提示:OSAS老年脑卒中患者存在明显血管内皮功能障碍,伴脑卒中者为甚,血管内皮功能损伤可能是OSAS患者并发脑卒中的原因之一.

Study on oxidative stress parameters and pathogenesis in elderly patients with obstructive sleep apnea syndrome combined with cerebrovascular disease

Objective To investigate the concentration changes of vascular endothelial growth factor(VEGF), nitric oxide(NO) and endothelin (ET) in elderly patients with obstructive sleep apnea syndrome (OSAS) combined with eerebrovascular disease.Methods One hundred and thirty-two subjects were divided into four groups: OSAS with cerebrovaseular disease group (OC group), OSAS without cerebrovascular disease group (O group), cerebrovascular disease without OSAS group (C group) and normal control group (N group).The concentrations of VEGF, NO and ET in the plasma were compared in each subgroup.Results The concentration of VEGF was significantly increased in OC group and O group compared with C group and N group[(195.34±56.7)ng/L, (162.34±48.7)ng/L, (156.4 4±51.8) ng/L, (114.1 ± 54.2) ng/L, F= 21.02, P< 0.05].The concentration of NO was increased gradually in OC group, C group, O group and N group[(62.3±4.9)mmol/L,(64.7±5.1) mmol/L, (66.2± 4.2)retool/L, (77.5 ± 6.8) mmol/L, F= 17.35, P<0.05], and the concentration of ET was decreased gradually in OC group, C group, O group and N group[(59.8±9.6)ng/L, (56.5±4.3)ng/L, (54.7±7.9)ng/L, (37.2±8.5)ng/L, F= 4.27, P<0.05].Conclusions The concentrations of VEGF and ET are increased and the concentration of NO is decreased in patients with OSAS.Patients with OSAS combined with cerebrovascular disease have higher VEGF and ET concentrations and lower NO concentration than in patients with simple OSAS.The results indicate that vascular endothelial dysfunction may play an important role in the development of cerebrovascular disease in patients with OSAS.