正压通气对OSAHS患者血清和呼出气冷凝液中内皮素-1及一氧化氮水平的影响

目的探讨自动调节持续气道正压通气(auto-CPAP)治疗对OSAHS患者血管内皮功能紊乱的影响。方法对确诊为OSAHS的实验组进行三个月auto-CPAP治疗,分别测定三个月前后两组血清及EBC中ET-1及NO水平,以及颈动脉内膜中层厚度(IMT)。结果实验组血清和EBC中ET-1水平以及EBC中NO水平均明显下降,IMT较前减少。血清和EBC中ET-1及NO水平与AHI等睡眠监测指标存在相关性。结论 EBC中ET-1及NO水平检测可了解OSAHS患者血管内皮功能紊乱,这种异常可以通过auto-CPAP治疗改善。

Effects of CPAP therapy on the Concentrations of Endothelin-1 and Nitric Oxide in Blood and Exhaled breath condensate of patients with obstructive sleep apnea

Objective To investigate the effect of auto-CPAP therapy on disturbance of vascular endothelium in patients with obstructive sleep apnea/ hypoventilation syndrome(OSAHS) and the clinical significance of testing Endothelin-1 and Nitric Oxide in exhaled breath condensate(EBC) of patients with OSAHS.Methods 42 patients with moderate-to-severe OSAHS were randomly allocated to the active group.The active group received the treatments of three months’auto-CPAP.Endothelin-1 and Nitric Oxide levels in plasma and EBC were measured before and after 3 months.Philips iU22 color doppler ultrasound instrument was used to measure intima-medial thickness(IMT) of jugular arteries.Results Between before treatment and after the three months,there were significant decrease in AHI,Endothelin-1 levels in plasma and EBC in the active group,and Nitric Oxide levels in EBC were lower.Endothelin-1 levels and Nitric Oxide levels in plasma and EBC were correlated with AHI,LSpO2,MSpO2 and IMT,but Nitric Oxide levels in EBC showed no correlation with IMT.Conclusion The disturbance of vascular endothelium in patients with OSAHS can be evaluated by testing Endothelin-1 and Nitric Oxide in their EBC,which can be improved by the auto-CPAP treatment.