阻塞性睡眠呼吸暂停低通气综合征程度与血压变异性和血清瘦素相关性研究

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)程度与血压变异性和血清瘦素(leptin,LEP)的相关性。 方法 118例OSAHS患者经多导睡眠图(polysomnogram,PSG)检查获得睡眠呼吸暂停低通气指数(apnea hypopnea index,AHI),并根据AHI评分分为轻度组、中度组、重度组,同时纳入40名健康人群作为对照组,监测各组24 h动态血压(ambulatory blood pressure,ABP),并采用酶联免疫吸附法检测各组的血清瘦素。 结果 ①AHI与血清瘦素方面,对照组、轻度组、中度组、重度组逐渐升高,组间比较差异有统计学意义(P<0.05)。②与对照组相比,OSAHS各组SBP_昼、DBP_夜水平均高于对照组,中度组、重度组的SBP_夜水平高于对照组(P<0.05);与轻度组相比,中度组、重度组的SBP_昼、SBP_夜、DBP_夜的水平高于轻度组(P<0.05);与中度组比,重度组SBP_昼、DBP_夜水平高于中度组(P<0.05)。③疾病程度与AHI、瘦素、SBP_昼、SBP_夜、DBP_夜呈正相关(P<0.05)。 结论 OSAHS疾病程度与血压变异性和血清瘦素密切相关,为OSAHS患者的疾病程度分级提供了新的思路,对本病的诊疗具有指导意义。 

Correlation between the degree of obstructive sleep apnea-hypopnea syndrome and blood pressure variability and serum leptin level

Objective To investigate the correlation between degree of obstructive sleep apnea hypopnea syndrome (OSAHS) and blood pressure variability and serum level of leptin. Methods A total of 118 patients with OSAHS were enrolled,and the sleep apnea hypopnea index (AHI) was measured by polysomnogram (PSG) examination.According to the AHI,they were divided into the mild group,the moderate group and the severe group;while 40 healthy persons were included as the control group.The 24 hours ambulatory blood pressure (ABP) and the serum level of leptin were tested by Enzyme-linked immunosorbent assay (ELISA). Results ①As the aspects of index of AHI and serum level of leptin,the control group,the mild group,the moderate group,and the severe group were all gradually increased with a statistically significant differences (P<0.05).②When compared with the control group,SBP_day and DBP_night levels of OSAHS groups'were higher than those of the control group,and the SBP_night level of the moderate group and the severe group were higher than those of the control group (P<0.05).As compared with the mild group,the SBP_day,SBP_night,DBP_night level of the moderate group and the severe group were higher than those of the mild group (P<0.05).As compared with the moderate group,the severe group's SBP_day and DBP_night were higher than those of the moderate group (P<0.05).③The degree of disease was positively correlated with index of AHI,serum level of leptin,level of SBP_day,SBP_night,and DBP_night,and there was a significant difference among these groups (P<0.05). Conclusion The severity degree of OSAHS is closely related to blood pressure variability and serum leptin,which provides a new way for the classification of patients with OSAHS,and it has guiding significance for the diagnosis and treatment of this disease.