阻塞性睡眠呼吸暂停低通气综合征患者的血管内皮舒张功能

目的评价阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的血管内皮功能。方法OSAHS患者30例(轻度组8例,中重度组22例)及对照组10例,分别用高分辨率超声检测基础状态、反应性充血时(内皮依赖性血管扩张)以及含服硝酸甘油后(非内皮依赖性血管扩张)的肱动脉内径,计算不同状态下肱动脉的扩张率以评估血管内皮功能。结果对照组、轻度和中重度OSAHS组患者反应性充血时肱动脉内径扩张率分别为(15.2±2.6)%、(14.3±3.2)%和(9.8±4.9)%,中重度OSAHS组患者血管内皮介导的舒张反应较对照组和轻度OSAHS组明显降低;含服硝酸甘油后肱动脉内径扩张率分别为(16.5±5.0)%、(15.7±4.1)%和(14.1±6.2)%,3组间无明显差别。结论中重度OSAHS患者存在血管内皮功能障碍,OSAHS本身可能是导致血管内皮损伤的重要因素。

Endothelium-dependent vasodilation in patients with obstructive sleep apnea-hypopnea syndrome

OBJECTIVE: To evaluate the endothelial function in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) by measuring the brachial artery diameter during reactive hyperemia. METHODS: Thirty patients with OSAHS (8 with mild and 22 with moderate/severe OSAHS) and 10 control subjects were studied. Brachial artery diameter was measured with Doppler ultrasound under baseline conditions, during reactive hyperemia (an endothelium-dependent dilatation) and after sublingual administration of nitroglycerin (an endothelium-independent vasodilator). The dilative rate of brachial artery in different conditions was calculated to evaluate the endothelial function. RESULTS: The dilative rate of brachial artery in the control group, the mild OSAHS group and the moderate/severe OSAHS group were (15.2 +/- 2.6)%, (14.3 +/- 3.2)% and (9.8 +/- 4.9)%, respectively. There was a significant decrease of endothelium-dependent flow-mediated dilation in the moderate/severe OSAHS group compared to the control group and the mild OSAHS group. No significant difference in endothelium-independent vasodilator after sublingual administration of nitroglycerin was found among the three groups. CONCLUSION: Patients with moderate/severe OSAHS have impaired endothelium-dependent vasodilatation, and OSAHS itself maybe a risk factor for endothelial dysfunction.