阻塞性睡眠呼吸暂停综合征患者颈动脉弹性与氧化应激反应的关系

doi:10.6040/j.issn.1673-3770.0.2018.578

摘要/Abstract

摘要： 目的研究阻塞性睡眠呼吸暂停综合征(OSAS)患者颈动脉弹性与氧化应激反应的关系。方法招募因打鼾疑为OSAS的患者和健康志愿者,根据呼吸暂停低通气指数(AHI)分为对照组36例和OSAS组36例,两组的性别、年龄、BMI都进行匹配。ELISA法检测血清丙二醛(MDA)和谷胱甘肽(GSH),应用QIMT和QAS技术检测所有受试者双侧颈动脉内膜中层厚度(IMT)、扩张系数(DC)、顺应系数(CC)、脉搏波传导速度(PWV)及僵硬系数α、β,比较两组各参数的差异,应用相关性分析氧化应激和动脉弹性的影响因素,作多重线性回归分析IMT的独立危险因素。结果 OSAS组与对照组相比性别、年龄、BMI、高密度脂蛋白、尿微量白蛋白、胱抑素C、舒张压均无差异(P>0.05),而两组颈围、腰臀比、甘油三脂、总胆固醇、低密度脂蛋白、hs-CRP、胰岛素抵抗、血糖、收缩压以及睡眠检测各指标均有差异(P<0.05)。 OSAS组血清MDA与GSH水平比对照组高(P<0.05);OSAS组颈动脉IMT及动脉弹性与对照组无明显差异,与MDA与GSH水平无相关性。线性回归表明年龄和低密度脂蛋白是影响颈动脉内膜中层厚度的独立危险因素。结论 OSAS患者氧化应激反应增加,但是尚不足以影响颈动脉弹性。年龄和低密度脂蛋白是影响颈动脉内膜中层厚度的独立危险因素。

关键词: 阻塞性睡眠呼吸暂停综合征, 颈动脉内膜中层厚度, 动脉弹性, 氧化应激

Abstract: Objective This study aimed to investigate the relationship between carotid elasticity and oxidative stress in patients with obstructive sleep apnea syndrome(OSAS). Methods Patients with suspected OSAS, and healthy volunteers were recruited. According to the apnea-hypopnea index, 36 patients each were enrolled in the OSAS group and control group. The sex, age, and body mass index(BMI)of the two groups were matched. Serum malondialdehyde(MDA)and glutathione(GSH)levels were estimated using enzyme-linked immunosorbent assay. Quality intima-media thickness(QIMT)and quality arterial stiffness(QAS)techniques were used to detect the bilateral carotid intima-media thickness(IMT), distensibility coefficient, compliance coefficient, pulse wave velocity, and stiffness coefficients α and β. The correlation factors between oxidative stress and arterial elasticity were analyzed by correlation analysis. Multiple linear regression analysis was used to analyze the independent risk factors of IMT. Results There was no difference in sex, age, BMI, high-density lipoprotein, urinary microalbumin, cystatin C, and diastolic blood pressure between the OSAS group and the control group (P>0.05). Triglyceride, total cholesterol, low-density lipoprotein, high-sensitivity C-reactive protein, insulin resistance, blood glucose, systolic blood pressure, and sleep parameters of the two groups were significantly different (P<0.05). Serum MDA and GSH levels were higher in the OSAS group than in the control group (P<0.05). There was no significant difference in carotid IMT and arterial elasticity between the groups. Carotid IMT and arterial elasticity were not correlated with MDA and GSH levels. Linear regression showed that age and low-density lipoprotein were independent risk factors for carotid IMT. Conclusion The increased oxidative stress response in patients with OSAS is insufficient to affect carotid elasticity. Age and low-density lipoprotein are independent risk factors for carotid IMT.

Key words: Obstructive sleep apnea syndrome, Carotid intima-media thickness, Arterial elasticity, Oxidative stress

中图分类号:

R766.43

宋凡,黄炜峻,许华俊,关建,易红良. 阻塞性睡眠呼吸暂停综合征患者颈动脉弹性与氧化应激反应的关系[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 99-104.

SONG Fan, HUANG Weijun, XU Huajun, GUAN Jian, YI Hongliang. Relationship between carotid elasticity and oxidative stress in patients with obstructive sleep apnea syndrome[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(4): 99-104.

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