老年OSAHS患者并发高血压机制研究.docVIP

老年OSAHS患者并发高血压机制研究 　　[摘要] 目的 探讨老年阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者并发高血压的机制及经鼻气道持续正压通气（n-CPAP）治疗的疗效。 方法 对经多导睡眠图（PSG），动态血压监测的老年OSAHS伴和不伴高血压患者、健康老年人，测定一氧化氮（NO）和内皮素1（ET1），并与PSG监测参数进行相关性分析。对10例中、重度OSAHS伴高血压患者进行n-CPAP治疗，1个月后复测动态血压和NO、ET1。 结果 老年OSAHS伴高血压，不伴高血压患者较老年健康人的NO值明显降低（P＜0.01），ET1值较健康老年人明显上升（P＜0.01），并与PSG监测的参数呈相关性。10例中、重度OSAHS伴高血压的患者经n-CPAP治疗后，NO值较治疗前明显提高（P＜0.05），ET1值较治疗前明显降低（P＜0.05），血压均值较治疗前明显下降（P＜0.05）。 结论 老年OSAHS患者存在内皮功能受损，n-CPAP治疗能改善血管内皮功能，使升高的血压趋于正常。 　　[关键词] 老年；阻塞性睡眠呼吸暂停低通气综合征；高血压；一氧化氮； 内皮素1 　　[中图分类号] R762 [文献标识码] B [文章编号] 1673-9701（2012）02-0045-03 　　 　　Study on the mechanism of obstructive sleep apnea-hypopnea syndrome in elderly patiens with hypertension 　　TANG Tingyu WU Jian QIN Guangyue 　　Department of Respiratory, Zhejiang hospital, Hangzhou 310013, China 　　[Abstract] Objective To explore the mechanism of obstructive sleep apnea-hypopnea syndrome (OSAHS) on old patients with hypertension and the curative effect of nasal continuous positive airway pressure or n-CPAP. Methods We Analyzed the correlation between nitric oxide (NO) and endothelin 1 (ET1). and we used ELISA to detect their values on old OSAHS patients with and without hypertension as well as healthy old people who have undergone PSG examination and ambulatory blood pressure monitoring (ABPM). Applying n-CPAP treatment on 10 moderate and severe OSAHS patients with hypertension and redetecting their 24-hour ambulatory blood pressure and NO and ET1. Results The level of NO on old OSAHS patients (with and without hypertension) was significantly lower (P＜0.01) while their ET1 level was significantly higher than healthy old people (P＜0.01). Those two figures were also correlated to PSG monitoring parameters. After n-CPAP treatment， the NO level of the moderate and severe OSAHS patients with hypertension was increased considerably (P＜0.05), while their ET1 level was declined remarkably (P＜0.05). The average blood pressure was also decreased (P＜0.05）. Conclusion There is endothelium dysfunction on old O