黏附分子在阻塞性睡眠呼吸暂停低通气综合征合并高血压发病中的作用

目的 探讨细胞黏附分子在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压(HT)发病中的作用。方法 应用酶联免疫吸附测定(ELISA)方法检测30例OSAHS血压正常患者(OSAHS组)、30例OSAHS合并高血压患者(OSAHS HT组)及30名健康者(正常对照组)血清中可溶性胞间黏附分子1(ICAM-1)、血管细胞黏附分子1(VCAM-1)和L-选择素的含量。结果 OSAHS HT组及OSAHS组患者血清可溶性ICAM-1分别为(601±406)μg/,L、(513±244)μg/L]、VCAM-1含量分别为(578±176)μg/L、(480±144)μg/L]均明显高于正常对照组分别为(355±119)μg/L、(310±163)μg/L,q值分别为4.78,3.07;9.09,5.76,P<0.01],差异有显著性;而L-选择素与对照组相比,差异无显著性(P>0.05);OSAHS HT组的VCAM-1明显高于OSAHS组(q值为3.32,P<0.05),差异有显著性;ICAM-1水平与睡眠呼吸暂停低通气指数(AHI)及微觉醒指数呈明显的正相关(r=0.465,P<0.01,r=0.226,P<0.05);与最低血氧饱和度呈明显的负相关(r=-0.368,P<0.01)。结论 血清ICAM-1、VCAM-1水平的升高是OSAHS患者高血压发病的重要危险因子之一。

The role of adhesion molecules in the pathogenic mechanisms of hypertension in obstructive sleep apnea-hypopnea syndrome

OBJECTIVE: To explore the role of adhesion molecules in the pathogenesis of hypertension in obstructive sleep apnea-hypopnea syndrome (OSAHS). METHODS: The levels of serum soluble intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and L-selectin in 30 OSAHS patients accompanied by hypertension, 30 normotensive OSAHS patients and 30 healthy controls were measured by enzyme-linked immunosorbent assay (ELISA) method. The relationship of the concentration of ICAM-1, VCAM-1 and L-selectin with the polysomnogram (PSG) parameters was analyzed. RESULTS: The levels of serum soluble ICAM-1 (601 +/- 406) microg/L, (513 +/- 244) microg/L, respectively] and VCAM-1 (578 +/- 176) microg/L, (480 +/- 144) microg/L, respectively] were significantly higher in OSAHS accompanied by hypertension and normotensive OSAHS than those in the healthy controls (355 +/- 119) microg/L, (310 +/- 163) microg/L, q = 4.78, 3.07; 9.09, 5.76, P < 0.01, respectively]. But the levels of serum L-selectin was not significantly different among the three groups (P > 0.05). The levels of serum VCAM-1 were significantly higher in OSAHS accompanied by hypertension than those in the normotensive OSAHS (q = 3.32, P < 0.05). The was not significantly different between the two groups (P > 0.05). There was a significantly positive correlation between the concentration of ICAM-1 and the apnea hyponea index (AHI) as well as microarousal index in all the 60 OSAHS patients with and without hypertension (r = 0.465, P < 0.01, r = 0.226, P < 0.05). There was a significantly negative correlation between the concentration of ICAM-1 and the lowest oxygen desaturation in all the 60 OSAHS patients with and without hypertension (r = -0.368, P < 0.01). CONCLUSION: The high level of serum VCAM-1 and ICAM-1 is an important risk factor for the development of hypertension in OSAHS patients.