阻塞性睡眠呼吸暂停综合征合并高血压持续正压通气后对血管内皮生长因子的影响

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摘要目的探讨阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea hypopnea syndrome, OSAHS)合并高血压患者持续正压通气(continuous positive airway pressure,CPAP)后对血管内皮生长因子(vascular endothelial growth factor, VEGF)的影响。方法选取47~57岁OSAHS合并高血压患者45例,对所有入选病例进行PSG监测和血压监测,并根据监测的通气结果分组。对所有患者进行CPAP治疗,之后再次行PSG监测和血压监测。考察以下指标:AHI、SaO₂、收缩压、舒张压、平均动脉压、血VEGF因子浓度。结果 OSAHS合并高血压患者经CPAP治疗后,PSG监测通气指标均有改善,血压下降;三组治疗后VEGF因子浓度为(40.77±13.19)pg/ml、(41.92±15.84)pg/ml、(56.06±18.91)pg/ml,与三组治疗前VEGF因子浓度相比明显降低,治疗前分别为(52.07±15.82)pg/ml、(74.11±21.20)pg/ml、(92.79±24.03)pg/ml,差异有统计学意义(P<0.05);VEGF浓度与各项指标之间呈现典型的正相关,其中与AHI、SaO₂,以及舒张压之间的相关性极为显著。结论 CPAP治疗OSAHS合并高血压患者效果显著,阻塞性睡眠呼吸障碍造成患者体内形成低氧环境,VEGF因子水平显著增高,可诱发血管增生,最终导致高血压形成。

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	桑城
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	刘志

关键词 ： OSAHS合并高血压, 持续性正压通气, VEGF因子

Abstract：Objective To investigate the changes of vascular endothelial growth factors (VEGF) in patients with hypertension and obstructive sleep apnea syndrome (OSAHS) after continuous positive airway pressure (CPAP). Methods Forty-five patients aged 47 to 57 were divided into 3 groups according to results of PSG monitoring and ABP. AHI, SaO₂, blood pressure and blood VEGF concentration were observed before and after CPAP therapy. Results After CPAP treatment, PSG index and blood pressure monitoring indicators in OSAHS patients with hypertension were toward the positive direction. VEGF expression decreased significantly; and before treatment, VEGF factor levels in three groups were (52.07±15.82), (74.11±21.20), (92.79±24.03)pg/ml respectively; after treatment, VEGF factor levels in three groups were (40.77±13.19), (41.92±15.84), (56.06±18.91)pg/ml, respectively. There was significant difference in VEGF factor before and after treatment (P<0.05); correlation between VEGF and the remaining indicators was typically positive, and correlations between VEGF and SaO₂, AHI, diastolic blood pressure were extremely significant. Conclusions CPAP therapy is significantly effective in treating OSAHS patients with hypertension. OSAHS creats a hypoxia internal environment in the patients. VEGF raises and promotes formation of hypertension.

Key words： obstructive sleep apnea hypopnea syndrome continuous positive airway pressure vascular endothelial growth factor

收稿日期: 2015-01-13

ZTFLH:

R541.3

作者简介: 桑城,硕士,主治医师,E-mail:lesson1980@hotmail.com

引用本文:

桑城, 许骥, 刘志. 阻塞性睡眠呼吸暂停综合征合并高血压持续正压通气后对血管内皮生长因子的影响[J]. 武警医学, 2015, 26(8): 761-764. SANG Cheng, XU Ji, LIU Zhi. Changes of VEGF factor in patients with hypertension and OSAHS after continuous positive airway pressure. Med. J. Chin. Peop. Armed Poli. Forc., 2015, 26(8): 761-764.

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http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2015/V26/I8/761

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