阻塞性睡眠呼吸暫停低通氣綜合征合并高血壓患者血漿同型半胱氨酸的變化_Chinese Journal of Respiratory and Critical Care Medicine

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徐春華 ¹ , 林勇 ²

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阻塞性睡眠呼吸暫停低通氣綜合征; 高血壓; 同型半胱氨酸

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目的探討同型半胱氨酸( HCY) 在OSAHS 合并高血壓發病中的作用。方法檢測22例OSAHS 合并高血壓患者、20 例OSAHS不伴高血壓患者血漿HCY 水平, 并與對照組比較, 將檢測結果與睡眠呼吸監測( PSG) 指標進行相關性分析。PSG 監測指標包括呼吸暫停低通氣指數( AHI) 、血氧飽和度小于90% 占總睡眠時間百分比( SLT90% ) 、最低血氧飽和度( LSaO2 ) 、平均血氧飽和度( MSaO2 ) 、覺醒指數( AI) 、睡眠呼吸暫停最長時間( LAT) 。結果 OSAHS 不伴高血壓患者血漿HCY明顯高于對照組[ ( 18. 28 ±6. 80) μmol /L 比( 6. 32 ±3. 95) μmol /L, P lt;0. 01] , OSAHS 合并高血壓組與OSAHS 不伴高血壓組比較血漿HCY 進一步升高[ ( 23. 83 ±5. 90) μmol /L 比( 18. 28 ±6. 80) μmol /L, P lt;0. 01] 。血漿HCY 水平與OSAHS 不伴高血壓組及OSAHS 合并高血壓組的AHI、SLT90% 均呈正相關( P 均 lt;0.01) , 與LSaO2、MSaO2 均呈負相關( P 均 lt;0. 01) 。結論 HCY 參與了OSAHS 的病理生理過程, 在OSAHS 合并高血壓患者發病中起一定作用。

Citation： 徐春華,林勇. 阻塞性睡眠呼吸暫停低通氣綜合征合并高血壓患者血漿同型半胱氨酸的變化. Chinese Journal of Respiratory and Critical Care Medicine, 2010, 9(2): 195-197. doi: Copy

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1. Arruda-Olson AM, Olson LJ, Nehra A, et al. Sleep apnea and cardiovascular disease. Implications for understanding erectile dysfunction. Herz, 2003 , 28: 298-303.
2. Del-Colle S, Renata C, Farrar R, et al. Hypertension in obstructive sleep apnoea. Vascular Disease Prevention, 2005, 2: 29-35.
3. Nieto FJ, Young TB, Lind BK, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large community-based study. Sleep Heart Health Study. JAMA, 2000, 283: 1829-1836.
4. Montalescot G, Ankri A, Chadefaux-Vekemans B, et al. Plasma homocysteine and the extent of atherosclerosis in patients with coronary artery disease. Int J Cardiol, 1997, 60 : 295-300.
5. 中華醫學會呼吸病學分會睡眠呼吸疾病學組. 阻塞性睡眠呼吸暫停低通氣綜合征診治指南( 草案) . 中華結核和呼吸雜志,2002, 25: 195-198 .
6. 中國高血壓防治指南起草委員會. 中國高血壓防治指南( 試行本) . 北京: 中華人民共和國衛生部/ 中國高血壓聯盟, 2005, 14 -17.
7. Lavie L. Obstructive sleep apnoea syndrome--an oxidative stress disorder. Sleep Med Rev, 2003, 7 : 35-51.
8. Lavie L, Perelman A, Lavie P. Plasma homocysteine in obstructive sleep apnoea. Chest, 2001 , 120: 900-908 .
9. Svatikova A, Wolk R, Magera MJ, et al. Plasma homocysteine in obstructive sleep apnoea. Eur Heart J, 2004, 25: 1325-1329.
10. Can M, A ikg z S, Mungan G, et al. Serum cardiovascular risk factors in obstructive sleep apnea. Chest, 2006, 129 : 233-237.
11. Jordan W, Berger C, Cohrs S, et al. CPAP-therapy effectively lowers serum homocysteine in obstructive sleep apnea syndrome. J Neural Transm, 2004, 111 : 683-689.
12. Kokturk O, Ciftci TU, Mollarecep E, et al. Serum homocysteine levels and cardiovascular morbidity in obstructive sleep apnea syndrome. Respir Med, 2006, 100: 536-541.

Chinese Journal of Respiratory and Critical Care Medicine

阻塞性睡眠呼吸暫停低通氣綜合征合并高血壓患者血漿同型半胱氨酸的變化

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