丁苯酞对重度老年OSAHS患者血浆一氧化氮和内皮素-1的影响
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摘要
目的:探讨丁苯酞对重度老年OSAHS患者血浆一氧化氮(NO)和内皮素-1(ET-1)的影响及临床意义。方法:将120例经PSG确诊的重度老年OSAHS患者随机分为无创呼吸机对照组、丁苯酞治疗组和丁苯酞联合无创呼吸机组,每组40例。无创呼吸机对照组患者行双水平气道正压通气治疗6个月,丁苯酞治疗组患者口服丁苯酞治疗6个月,丁苯酞联合无创呼吸机组患者在行双水平气道正压通气治疗的同时,口服丁苯酞治疗6个月,分别于治疗前及治疗3、6个月后采用免疫酶联吸附法检测血浆NO、ET-1水平的变化,并进行对比分析。结果:3组患者治疗前血浆NO和ET-1比较差异无统计学意义(P>0.05);与治疗前比较,3组患者治疗3、6个月后血浆NO水平升高,ET-1水平下降(P<0.01);与丁苯酞治疗组治疗后比较,无创呼吸机对照组及丁苯酞联合无创呼吸机组患者治疗3、6个月后血浆NO水平升高,ET-1水平下降,差异有统计学意义(P<0.05);与无创呼吸机对照组比较,丁苯酞联合无创呼吸机组患者治疗3、6个月后血浆NO水平升高,ET-1水平下降,差异有统计学意义(P<0.05)。结论:丁苯酞可通过升高血浆NO、降低血浆ET-1的水平改善重度老年OSAHS患者的血管内皮功能。
Objective:To investigate the effect of butylphthalide on plasma nitric oxide(NO)and endothelin-1(ET-1)in severe elderly OSAHS patients.Method:A total of 120 severe elderly OSAHS patients were chosen by PSG measurement.According to random number table method,OSAHS patients were randomly divided into noninvasive ventilation control group(n=40),butylphthalide treatment group(n=40)and butylphthalide combined with non-invasive ventilation group(n=40).Non-invasive ventilation control group was given double level airway positive pressure ventilation treatment for six months,butylphthalide treatment group accepted oral butylphthalide therapy for six months,butylphthalide combined with non-invasive ventilation group was given double level airway positive pressure ventilation treatment and accepted oral butylphthalide therapy for six months.The changes of plasma NO and ET-1 were detected by immunoenzyme adsorption before treatment and three and six months after treatment.Result:The difference of plasma NO and ET-1 before treatment in the three groups was not statistically significant(P>0.05).Compared with before treatment,the level of plasma NO decreased and the level of plasma ET-1 increased in the three groups after three and six months treatment(P <0.01).Compared with butylphthalide treatment group,the level of plasma NO increased and the level of plasma ET-1 decreased after 3 and 6 months of treatment in both non-invasive ventilation control group and butylphthalide combined with non-invasive ventilation group(P<0.05).Compared with non-invasive ventilation control group,the level of plasma NO increased and the level of plasma ET-1 decreased after 3 and 6 months of treatment in butylphthalide combined with non-invasive ventilation group(P<0.05).Conclusion:Butylphthalide may improve the vascular endothelial function of severe elderly OSAHS patients by increasing the level of NO and decreasing the level of ET-1 in plasma.
Objective:To investigate the effect of butylphthalide on plasma nitric oxide(NO)and endothelin-1(ET-1)in severe elderly OSAHS patients.Method:A total of 120 severe elderly OSAHS patients were chosen by PSG measurement.According to random number table method,OSAHS patients were randomly divided into noninvasive ventilation control group(n=40),butylphthalide treatment group(n=40)and butylphthalide combined with non-invasive ventilation group(n=40).Non-invasive ventilation control group was given double level airway positive pressure ventilation treatment for six months,butylphthalide treatment group accepted oral butylphthalide therapy for six months,butylphthalide combined with non-invasive ventilation group was given double level airway positive pressure ventilation treatment and accepted oral butylphthalide therapy for six months.The changes of plasma NO and ET-1 were detected by immunoenzyme adsorption before treatment and three and six months after treatment.Result:The difference of plasma NO and ET-1 before treatment in the three groups was not statistically significant(P>0.05).Compared with before treatment,the level of plasma NO decreased and the level of plasma ET-1 increased in the three groups after three and six months treatment(P <0.01).Compared with butylphthalide treatment group,the level of plasma NO increased and the level of plasma ET-1 decreased after 3 and 6 months of treatment in both non-invasive ventilation control group and butylphthalide combined with non-invasive ventilation group(P<0.05).Compared with non-invasive ventilation control group,the level of plasma NO increased and the level of plasma ET-1 decreased after 3 and 6 months of treatment in butylphthalide combined with non-invasive ventilation group(P<0.05).Conclusion:Butylphthalide may improve the vascular endothelial function of severe elderly OSAHS patients by increasing the level of NO and decreasing the level of ET-1 in plasma.
引文
[1]HOLTSTRAND HJLM H,FU M,HANSSON PO,et al.Association between left atrial enlargement and obstructive sleep apnea in a general population of71-year-old men[J].J Sleep Res,2018,27:252-258.
[2]黄超,李立群,王立民,等.重度阻塞性睡眠呼吸暂停低通气综合征患者血浆同型半胱氨酸和内皮素-1与血脂代谢的关联[J].实用医学杂志,2015,31(23):3874-3876.
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[4]MCDERMOTT M,BROWN D L,CHERVIN R D.Sleep disorders and the risk of stroke[J].Expert Rev Neurother,2018,18:523-531.
[5]聂晓敏,苏利霄,周雅婧,等.大蒜素对冠心病合并阻塞性睡眠呼吸暂停低通气综合征患者血管内皮功能的影响[J].中华医学杂志,2014,94(28):2184-2187.
[6]SEIF F,PATEL S R,WALIA H,et al.Association between obstructive sleep apnea severity and endothelial dysfunction in an increased background of cardiovascular burden[J].J Sleep Res,2013,22:443-451.
[7]陈碧,张文辉,陈玉玲,等.阻塞性睡眠呼吸暂停低通气综合征与颈动脉粥样硬化的相关性及持续气道正压通气治疗的作用[J].中华医学杂志,2015,95(34):2791-2795.
[8]韦俊杰,李吕力,李晓峰,等.丁苯酞对脑缺血再灌注大鼠血管内皮生长因子和血管生成素-1的影响[J].中华行为医学与脑科学杂志,2016,25(9):774-777.
[9]NIU H,ZHANG Z,WANG H,et al.The impact of butylphthalide on the hypothalamus-pituitary-adrenal axis of patients suffering from cerebral infarction in the basal ganglia[J].Electron Physician,2016,8:1759-176.
[10]张盼盼,汪彦辉,韩晓庆,等.丁苯酞对老年OSAHS患者氧化应激及认知功能的影响[J].临床耳鼻咽喉头颈外科杂志,2018,32(18):1422-1425.
[11]中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版)[J].中华结核和呼吸杂志,2012,35(1):9-12.
[12]谢汉生,林其昌,陈公平,等.老年阻塞性睡眠呼吸暂停低通气综合征患者血清尿酸水平测定的意义[J].中华老年医学杂志,2016,35(8):858-861.
[13]FLORAS J S.Sleep apnea and cardiovascular risk[J].J Cardiol,2014,63:3-8.
[14]袁平,王文君,李东风,等.阻塞性睡眠呼吸暂停低通气综合征患者巨噬细胞移动抑制因子的表达及其与血管内皮细胞损伤的关系研究[J].中华结核和呼吸杂志,2016,39(11):871-875.
[15]张盼盼,韩晓庆,王红阳,等.持续气道正压通气对中重度阻塞性睡眠呼吸暂停综合征患者血清S100β及NSE的影响[J].临床耳鼻咽喉头颈外科杂志,2015,29(6):509-511.
[16]张盼盼,韩晓庆,王红阳,等.持续气道正压通气对老年睡眠呼吸暂停患者神经损伤因子的影响[J].中华老年心脑血管病杂志,2015,17(7):739-741.
[17]HUI D S,SHANG Q,KO F W,et al.A prospective cohort study of the long-term effects of CPAP on carotid artery intima-media thickness in obstructive sleep apnea syndrome[J].Respir Res,2012,13:22.
[18]张秀伟,蔡伟,晋发,等.双水平气道正压通气对重叠综合征患者心功能及血管内皮功能影响[J].中华结核和呼吸杂志,2011,34(1):17-20.
[19]LAVIE L.Oxidative stress inflammation and endothelial dysfunction in obstructive sleep apnea[J].Front Biosci(Elite Ed),2012,4:1391-1403.
[20]陈海恋,何超明,庞明武,等.丁苯酞治疗老年急性脑梗死的疗效及对细胞因子和神经功能的影响[J].中华老年心脑血管病杂志,2016,18(11):1173-1177.
[21]潘君枝,程超禅,陈瑞炳,等.丁苯酞治疗对急性脑梗死患者血管内皮功能与血栓形成的影响[J].中国老年学杂志,2015,35(13):3580-3582.
[2]黄超,李立群,王立民,等.重度阻塞性睡眠呼吸暂停低通气综合征患者血浆同型半胱氨酸和内皮素-1与血脂代谢的关联[J].实用医学杂志,2015,31(23):3874-3876.
[3]BOUZERDA A.Cardiovascular risk and obstructive sleep apnea[J].Pan Afr Med J,2018,29:47-54.
[4]MCDERMOTT M,BROWN D L,CHERVIN R D.Sleep disorders and the risk of stroke[J].Expert Rev Neurother,2018,18:523-531.
[5]聂晓敏,苏利霄,周雅婧,等.大蒜素对冠心病合并阻塞性睡眠呼吸暂停低通气综合征患者血管内皮功能的影响[J].中华医学杂志,2014,94(28):2184-2187.
[6]SEIF F,PATEL S R,WALIA H,et al.Association between obstructive sleep apnea severity and endothelial dysfunction in an increased background of cardiovascular burden[J].J Sleep Res,2013,22:443-451.
[7]陈碧,张文辉,陈玉玲,等.阻塞性睡眠呼吸暂停低通气综合征与颈动脉粥样硬化的相关性及持续气道正压通气治疗的作用[J].中华医学杂志,2015,95(34):2791-2795.
[8]韦俊杰,李吕力,李晓峰,等.丁苯酞对脑缺血再灌注大鼠血管内皮生长因子和血管生成素-1的影响[J].中华行为医学与脑科学杂志,2016,25(9):774-777.
[9]NIU H,ZHANG Z,WANG H,et al.The impact of butylphthalide on the hypothalamus-pituitary-adrenal axis of patients suffering from cerebral infarction in the basal ganglia[J].Electron Physician,2016,8:1759-176.
[10]张盼盼,汪彦辉,韩晓庆,等.丁苯酞对老年OSAHS患者氧化应激及认知功能的影响[J].临床耳鼻咽喉头颈外科杂志,2018,32(18):1422-1425.
[11]中华医学会呼吸病学分会睡眠呼吸障碍学组.阻塞性睡眠呼吸暂停低通气综合征诊治指南(2011年修订版)[J].中华结核和呼吸杂志,2012,35(1):9-12.
[12]谢汉生,林其昌,陈公平,等.老年阻塞性睡眠呼吸暂停低通气综合征患者血清尿酸水平测定的意义[J].中华老年医学杂志,2016,35(8):858-861.
[13]FLORAS J S.Sleep apnea and cardiovascular risk[J].J Cardiol,2014,63:3-8.
[14]袁平,王文君,李东风,等.阻塞性睡眠呼吸暂停低通气综合征患者巨噬细胞移动抑制因子的表达及其与血管内皮细胞损伤的关系研究[J].中华结核和呼吸杂志,2016,39(11):871-875.
[15]张盼盼,韩晓庆,王红阳,等.持续气道正压通气对中重度阻塞性睡眠呼吸暂停综合征患者血清S100β及NSE的影响[J].临床耳鼻咽喉头颈外科杂志,2015,29(6):509-511.
[16]张盼盼,韩晓庆,王红阳,等.持续气道正压通气对老年睡眠呼吸暂停患者神经损伤因子的影响[J].中华老年心脑血管病杂志,2015,17(7):739-741.
[17]HUI D S,SHANG Q,KO F W,et al.A prospective cohort study of the long-term effects of CPAP on carotid artery intima-media thickness in obstructive sleep apnea syndrome[J].Respir Res,2012,13:22.
[18]张秀伟,蔡伟,晋发,等.双水平气道正压通气对重叠综合征患者心功能及血管内皮功能影响[J].中华结核和呼吸杂志,2011,34(1):17-20.
[19]LAVIE L.Oxidative stress inflammation and endothelial dysfunction in obstructive sleep apnea[J].Front Biosci(Elite Ed),2012,4:1391-1403.
[20]陈海恋,何超明,庞明武,等.丁苯酞治疗老年急性脑梗死的疗效及对细胞因子和神经功能的影响[J].中华老年心脑血管病杂志,2016,18(11):1173-1177.
[21]潘君枝,程超禅,陈瑞炳,等.丁苯酞治疗对急性脑梗死患者血管内皮功能与血栓形成的影响[J].中国老年学杂志,2015,35(13):3580-3582.