阻塞性睡眠呼吸暂停低通气综合征合并高血压患者睡眠结构分析及血清内皮素-1的测定

Evaluation of the serum endothelin-1 level and sleep architecture change in patients with obstructive sleep apnea hypopnea syndrome accompanied hypertension]

OBJECTIVE: To explore the role of endothelin-1 (ET-1) in the pathogenesis of hypertension in obstructive sleep apnea hypopnea syndrome (OSAHS). METHODS: The levels of serum ET-1 in 30 OSAHS patients accompanied by hypertension, 30 normotensive OSAHS patients and 30 healthy controls were measured by ET-1 enzyme immunoassay kit. Meanwhile the correlation about the concentration of ET-1 in OSAHS patients with the clinic, polysomnography (PSG) parameters was analyzed. RESULTS: OSAHS patients with or without hypertension compared with snoring group and normal people, the sleep structure was significantly disturbed. The time percentages of awake and stage I sleep were increased, while stage II sleep decreased significantly in OSAHS patients than those in snoring group (P < 0.01, respectively). There were no significantly difference about the sleep structure in the two OSAHS groups. The levels of serum ET-1 (mean +/- s) were significantly higher in OSAHS patients accompanied by hypertension and normotensive OSAHS patients(42.5 +/- 8.4) ng/L and (38.6 +/- 4.7) ng/L respectively than those in the healthy controls(33.1 +/- 5.4) ng/L (P < 0.01, respectively). In the two OSAHS groups, the levels of serum ET-1 were significantly higher in OSAHS patients accompanied by hypertension than those in the normotensive OSAHS patients (P < 0.05). There were positive correlations between the concentration of ET-1 and the apnea hypopnea index (AHI) in all the 60 OSAHS patients with and without hypertension (r = 0.334, P < 0.01). There were negative correlations between the concentration of ET-1 and the lowest oxygen desaturation in all the 60 OSAHS patients with and without hypertension (r = -0.230, P < 0.05). CONCLUSION: These results indicate that the sleep disordered breathing and hypoxia may contribute to the elevation of ET-1 in the OSAHS patients and OSAHS patients accompanied by hypertension. ET-1 may play an important role in the pathogenesis of OSAHS-induced hypertension.