阻塞性睡眠呼吸暂停低通气综合征93例临床分析

目的通过检测阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清血管内皮生长因子(VEGF)质量浓度,探讨其与肺动脉高压的关系。方法选择2003-02~2004-09温州医学院附属第一医院收治的93例因打鼾就诊的患者,对18例单纯鼾症、39例轻中度及36例重度OSAHS患者于多导睡眠图(PSG)检测后次日晨7:00测定其血清VEGF质量浓度,并予超声心动图检测了其中31例OSAHS患者肺动脉压力。结果PSG检测结果显示与单纯鼾症组比,OSAHS组存在夜间低氧;且重度组比轻中度OSAHS组夜间低氧更严重(均有统计学意义)。与单纯鼾症组比较,VEGF质量浓度在重度OSAHS组中明显升高(P<0·05),并分别与衡量病情及夜间低氧情况指标呈正相关,与夜间最低经皮血氧饱和度(SpO2)呈负相关。结论中重度OSAHS患者存在夜间低氧饱和度,同时有VEGF增高。

Clinical analysis of 93 patients with obstructive sleep apnea hypopnea syndrome

Objective To investigate the serum levels of vascular endothelial growth factor(VEGF)in patients with obstructive sleep apnea hypopnea syndrome(OSAHS),and make a primary relative study on the relationship between VEGF and pH.Methods Thirty-nine patients with mild to moderate OSAHS,36 patients with severe OSAHS and 18 healthy snorers who had been admitted to the First Hospital Affiliated to Wenzhou Medical College from Feb.2003 to Sep.2004 were enrolled in this study.The serum levels of VEGF were detected in all patients at 7:00 AM the next day after the detection of polysomnography(PSG).Additionally 31 patients with OSAHS were detected by doppler echocardiography to get the values of pulmonary artery pression.Results There was nocturnal hypoxia in patients with OSAHS compared with healthy snorers,and the degree of nocturnal hypoxia was depended with the grade of OSAHS(both achieved statistical difference)by the detection of PSG.The levels of VEGF was significantly higher in patients with severe OSAHS than in healthy snorers(P<0.05).VEGF were positively related to apnea-hypopnea index(AHI),the disturbance index of hypoxemia,the percentage of the period with nocturnal SpO_2 less than 90% in total sleep time and the longest duration of hypoxemia,and VEGF were negatively related to nadir of SpO_2(r=0.233,r=0.222,r=0.237,r=0.240,r=-0.240,P<0.05).Among 31 patients with OSAHS,two patients had pulmonary hyertension(6.5% in total).The serum levels of VEGF was not related to pulmonary artery pression(r=-0.082,P=0.730).Conclusion The serum levels of VEGF is significantly higher and there is nocturnal hypoxia in patients with moderate and severe OSAHS.