高血压伴OSAHS患者血AT1受体自身抗体水平与呼吸暂停低通气指数的关系
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摘要
目的探讨高血压伴阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者抗血管紧张素1受体(AT1)自身抗体水平与呼吸暂停低通气指数(AHI)的关系.方法选取200例高血压伴OSAHS患者为研究对象,纳入研究组,以同期确诊的单纯OSAHS患者100例为对照组,对比两组收缩压(SBP)、舒张压(DBP)、AHI等基线资料,比较轻、中、重度OSAHS患者SBP,DBP水平,分析高血压伴OSAHS患者SBP,DBP与AHI的相关性,同时对比两组血浆AT1自身抗体、内皮素(ET-1)、内源性一氧化氮(NO)水平,分析AT1自身抗体与SBP,DBP,AHI,ET-1,NO的相关性.结果研究组体质量指数、颈围、腰围、SBP、DBP、AHI均较单纯SAHS组高(P<0.05);随病病情程度加重,研究组SBP,DBP均显著增加,且研究组SBP,DBP显著高于对照组(P<0.05);高血压伴OSAHS患者SBP,DBP与AHI呈正相关(P<0.05);研究组AT1自身抗体、ET-1较对照组高,研究组NO水平与对照组比较明显低(P<0.05);相关分析显示:AT1自身抗体水平与SBP,DBP,AHI,ET-1呈正相关,而与NO水平呈负相关(P<0.05).结论高血压伴OSAHS患者血AT1受体的肾素-血管紧张素系统可能参与了OSAHS合并高血压的病变过程.
Objective To investigate the relationship between the levels of angiotensin 1 receptor( AT1)autoantibodies and apnea hypopnea index( AHI) in patients with hypertension and obstructive sleep apnea hypopnea syndrome( OSAHS). Method A total of 200 patients with hypertension and OSAHS were selected as the study group. Another 100 patients with simple OSAHS diagnosed in the same period were selected as the control group. The systolic blood pressure( SBP),diastolic pressure( DBP),AHI and other baseline datum were compared between the two groups. SBP and DBP of the patients with mild,moderate and severe OSAHS were compared. Correlation between SBP,DBP and AHIin patients with hypertension and OSAHS was analyzed. The levels of plasma AT1 autoantibodies,endothelin( ET-1) and endogenous nitric oxide( NO) were also compared between the two groups. And the correlation between AT1 autoantibodies and SBP,DBP,AHI,ET-1 and NO was analyzed. Results The body mass index( BMI),neck circumference,waist circumference,SBP,DBP and AHI ofthe study group were higher than those of the control group( P<0. 05). With the aggravation of the disease,SBP and DBP of the study group increased significantly,and were significantly higher than those of the control group( P<0. 05). SBP and DBP were positively correlated with AHI in the patients with hypertension and OSAHS( P<0. 05). Compared with the control group,AT1 autoantibodies and ET-1 levels of the study group were much higher,while NO level was significantly lower( P < 0. 05). Correlation analysis showed that the levels of AT1 autoantibodies were positively correlated with SBP,DBP,AHI and ET-1,but negatively correlated with NO( P <0. 05). Conclusion The levels of AT1 receptor autoantibodies are positively correlated with AHI and ET-1,and negtively correlated with NO in the patients with hypertension and OSAHS. The renin-angiotensin system with AT1 may be involved in the pathological process of OSAHS with hypertension.
Objective To investigate the relationship between the levels of angiotensin 1 receptor( AT1)autoantibodies and apnea hypopnea index( AHI) in patients with hypertension and obstructive sleep apnea hypopnea syndrome( OSAHS). Method A total of 200 patients with hypertension and OSAHS were selected as the study group. Another 100 patients with simple OSAHS diagnosed in the same period were selected as the control group. The systolic blood pressure( SBP),diastolic pressure( DBP),AHI and other baseline datum were compared between the two groups. SBP and DBP of the patients with mild,moderate and severe OSAHS were compared. Correlation between SBP,DBP and AHIin patients with hypertension and OSAHS was analyzed. The levels of plasma AT1 autoantibodies,endothelin( ET-1) and endogenous nitric oxide( NO) were also compared between the two groups. And the correlation between AT1 autoantibodies and SBP,DBP,AHI,ET-1 and NO was analyzed. Results The body mass index( BMI),neck circumference,waist circumference,SBP,DBP and AHI ofthe study group were higher than those of the control group( P<0. 05). With the aggravation of the disease,SBP and DBP of the study group increased significantly,and were significantly higher than those of the control group( P<0. 05). SBP and DBP were positively correlated with AHI in the patients with hypertension and OSAHS( P<0. 05). Compared with the control group,AT1 autoantibodies and ET-1 levels of the study group were much higher,while NO level was significantly lower( P < 0. 05). Correlation analysis showed that the levels of AT1 autoantibodies were positively correlated with SBP,DBP,AHI and ET-1,but negatively correlated with NO( P <0. 05). Conclusion The levels of AT1 receptor autoantibodies are positively correlated with AHI and ET-1,and negtively correlated with NO in the patients with hypertension and OSAHS. The renin-angiotensin system with AT1 may be involved in the pathological process of OSAHS with hypertension.
引文
[1]李小村,苏建华,沈燕青,等.CPAP治疗OSAHS合并难治性高血压患者的6个月疗效观察[J].临床肺科杂志,2017,22(2):291-293.
[2]李海玲,邱淑佳,黄蓓洁,等.阻塞性睡眠呼吸暂停低通气综合征患者不同睡眠体位下血氧饱和度下降指数和呼吸暂停低通气指数的变化分析[J].临床和实验医学杂志,2016,15(18):1813-1815.
[3]张新军.肾素-血管紧张素系统拮抗剂在高血压治疗中的应用[J].心血管病学进展,2015,36(6):673-676.
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[6]孙楷,聂洪玉,刘泳,等.自动持续气道正压通气结合压力预测治疗OSAHS的临床应用[J].西部医学,2016,28(4):501-504.
[7]姜永刚,王东海,李阳阳,等.CPAP对睡眠呼吸暂停低通气综合征合并2型糖尿病患者的疗效观察[J].湖南师范大学学报(医学版),2016,13(3):108-110.
[8]夏皓,黄兆辉,刘东凤,等.高血压合并OSAHS动态动脉硬化指数与呼吸暂停低通气指数的关系[J].中国老年学杂志,2016,36(5):1070-1071.
[9]张连国,畅懿,樊晓军,等.老年阻塞性睡眠呼吸暂停低通气综合征合并高血压患者血浆内ET-1及内源性NO表达及意义[J].医学临床研究,2015,32(3):505-507.
[10]刘伶俐,苏晓灵.阻塞性睡眠呼吸暂停低通气综合征诱发心血管疾病机制的研究进展[J].山东医药,2016,56(16):101-103.
[11]雷翔.血清血管紧张素转换酶的水平在阻塞性睡眠呼吸暂停低通气综合征患者中的变化研究[J].临床肺科杂志,2015,20(8):1461-1464.
[12]孙韬,臧崇森,许钟镐,等.血管紧张素Ⅱ1型受体功能研究进展[J].中国老年学杂志,2016,36(14):3591-3594,3595.
[13]陈君峰,邵海燕,顾海艇,等.睡眠呼吸暂停低通气综合征并发高血压患者血浆肾素、血管紧张素Ⅱ、醛固酮水平相关性研究[J].中国基层医药,2016,23(4):516-520.
[14]米热古丽·阿不都热合曼,买尔旦·阿布来.阻塞型睡眠呼吸暂停低通气综合征患者肾素、血管紧张素水平的研究[J].吉林医学,2014,35(36):8011-8012.
[15]徐小华,韩志强,田明庆,等.高血压合并阻塞性睡眠呼吸暂停低通气综合征患者持续气道正压通气治疗前后血压与血管紧张素水平的研究[J].浙江中医药大学学报,2014,38(5):595-597.
[2]李海玲,邱淑佳,黄蓓洁,等.阻塞性睡眠呼吸暂停低通气综合征患者不同睡眠体位下血氧饱和度下降指数和呼吸暂停低通气指数的变化分析[J].临床和实验医学杂志,2016,15(18):1813-1815.
[3]张新军.肾素-血管紧张素系统拮抗剂在高血压治疗中的应用[J].心血管病学进展,2015,36(6):673-676.
[4]程征,周子华,陈玺军.高血压患者血压节律与抗AT_1受体自身抗体及临床常见指标的相关性探讨[J].临床心血管病杂志,2016,32(8):806-810.
[5]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.
[6]孙楷,聂洪玉,刘泳,等.自动持续气道正压通气结合压力预测治疗OSAHS的临床应用[J].西部医学,2016,28(4):501-504.
[7]姜永刚,王东海,李阳阳,等.CPAP对睡眠呼吸暂停低通气综合征合并2型糖尿病患者的疗效观察[J].湖南师范大学学报(医学版),2016,13(3):108-110.
[8]夏皓,黄兆辉,刘东凤,等.高血压合并OSAHS动态动脉硬化指数与呼吸暂停低通气指数的关系[J].中国老年学杂志,2016,36(5):1070-1071.
[9]张连国,畅懿,樊晓军,等.老年阻塞性睡眠呼吸暂停低通气综合征合并高血压患者血浆内ET-1及内源性NO表达及意义[J].医学临床研究,2015,32(3):505-507.
[10]刘伶俐,苏晓灵.阻塞性睡眠呼吸暂停低通气综合征诱发心血管疾病机制的研究进展[J].山东医药,2016,56(16):101-103.
[11]雷翔.血清血管紧张素转换酶的水平在阻塞性睡眠呼吸暂停低通气综合征患者中的变化研究[J].临床肺科杂志,2015,20(8):1461-1464.
[12]孙韬,臧崇森,许钟镐,等.血管紧张素Ⅱ1型受体功能研究进展[J].中国老年学杂志,2016,36(14):3591-3594,3595.
[13]陈君峰,邵海燕,顾海艇,等.睡眠呼吸暂停低通气综合征并发高血压患者血浆肾素、血管紧张素Ⅱ、醛固酮水平相关性研究[J].中国基层医药,2016,23(4):516-520.
[14]米热古丽·阿不都热合曼,买尔旦·阿布来.阻塞型睡眠呼吸暂停低通气综合征患者肾素、血管紧张素水平的研究[J].吉林医学,2014,35(36):8011-8012.
[15]徐小华,韩志强,田明庆,等.高血压合并阻塞性睡眠呼吸暂停低通气综合征患者持续气道正压通气治疗前后血压与血管紧张素水平的研究[J].浙江中医药大学学报,2014,38(5):595-597.