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目的:探讨阻塞性睡眠呼吸暂停综合征(OSAHS)与椎动脉狭窄、血浆内皮素-1(ET-1)之间的关系。方法:选择经多导睡眠监测仪检测,睡眠呼吸暂停低通气指数(AHI)≥5次/h的104例OSAHS患者与AHI<5次/h的47例正常对照组患者作为研究对象,彩超检测患者椎动脉病变,酶联免疫反应测定血浆ET-1水平。结果:OSAHS组患者椎动脉狭窄发生率、斑块形成率明显高于对照组,分别为(29.8%vs12.8%)、(26.9%vs 10.6%),差异有统计学意义(P<0.05)。AHI与椎动脉V1、V2段平均血管内径(Vd)呈负相关(r=-0.31,P<0.05),与血浆ET-1水平无显著相关(P>0.05)。夜间最低动脉血氧(LSa O2)与Vd呈正相关,(r=0.36),与ET-1呈负相关(r=-0.41),均P<0.05。结论:OSAHS患者椎动脉狭窄、粥样硬化斑块发生率增高;反复呼吸暂停、夜间缺氧引起血浆ET-1升高可导致椎动脉损伤。
Objective: To investigate the relationship between obstructive sleep apnea syndrome (OSAHS) and vertebral artery stenosis and plasma endothelin-1 (ET-1). Methods: A total of 104 patients with OSAHS and 47 normal controls (AHI <5 times / h) who were tested by polysomnography, sleep apnea-hypopnea index (AHI) ≥5 beats per hour were enrolled in this study. Patients with vertebral artery lesions, serum ET-1 levels by enzyme-linked immunosorbent assay. Results: The incidence of vertebral artery stenosis and plaque formation in OSAHS group were significantly higher than those in control group (29.8% vs12.8%, 26.9% vs10.6%, respectively) (P <0.05) . AHI was negatively correlated with mean vascular diameter (Vd) of V1 and V2 of vertebral artery (r = -0.31, P <0.05), but not with plasma ET-1 level (P> 0.05). The nighttime minimum arterial oxygen (LSa O2) was positively correlated with Vd (r = 0.36), negatively correlated with ET-1 (r = -0.41), both P <0.05. Conclusion: The incidence of vertebral artery stenosis and atherosclerotic plaques in patients with OSAHS is high. Repeated apnea and nocturnal hypoxia may result in the injury of vertebral artery due to the elevation of ET-1.