目的:探讨阻塞性睡眠呼吸暂停综合征(OSAS)合并高血压病患者血浆血管内皮生长因子(VEGF)水平的变化及意义。方法:①36例单纯OSAS患者[(依据多导睡眠图PSG监测结果分为轻(7例)、中(10例)、重组(19例)]、14例OSAS合并高血压患者和20 例正常人,经PSG监测后,检测血浆VEGF 浓度。②给予14例OSAS 合并高血压患者经鼻持续正压通气(nCPAP) 治疗1周,观察治疗前后的血浆VEGF 浓度变化。结果:OSAS组,OSAS合并高血压组血浆VEGF水平都较正常对照组显著升高(P < 0.05),OSAS合并高血压组较单纯OSAS组VEGF水平明显增高(P < 0.05),OSAS各亚组组间VEGF水平无显著差异(P > 0.05),OSAS合并高血压组CPAP治疗后VEGF水平显著降低(P < 0.05)。结论:VEGF在单纯OSAS及OSAS合并高血压患者中均显著增高,VEGF促进血管内皮细胞的分裂增生及促进血管新生的功能可能对缓解OSAS的组织缺氧及减少其心脑血管的并发症有重要作用。CPAP治疗可在一定程度上降低OSAS患者的VEGF水平。
Objective:To investigate the significance of the vascular endothelial growth factor(VEGF) levels in obstructive sleep apnea syndrome(OSAS) associated with hypertension. Methods:The VEGF levels were measured in OSAS group(n = 36),OSAS plus hypertension group(n = 14) and control group(n = 20),before and after the continuous positive airway pressure(CPAP) treatment in OSAS plus Hypertension group respectively, and differences between each two groups were investigated. Results:The VEGF levels in simple OSAS group(n = 36)[(81.76 ± 10.81)pg/ml],and in OSAS plus hypertension group(n = 14)[(92.35 ± 7.49)pg/ml] were significant higher than that in the control group(n = 20)[(70.01 ± 5.71)pg/ml] espectively(P < 0.05), but there was no significant difference among the subgroups of OSAS(P > 0.05). The plasma VEGF levels in OSAS plus hypertensive group changed significantly from the baseline level(n = 14)[(92.35 ± 7.49)pg/ml] to the level[(72.56 ± 4.41)pg/ml ] after one week of CPAP treatment(P <0.05). Conclusion:Plasma VEGF levels in OSAS and hypertension patient were both higher than that in control group. Vascular endothelial growth factor(VEGF) may relieve OSAS and reduce the complication of cardiovascular disease by promoting vascular endothelial cell proliferation and angiogenesis as well as improving tissue hypoxia. There was a decrease in VEGF concentrations in OSAS plus hypertension group after CPAP treatment.
朱黎容,肖永龙,张德平.血管内皮生长因子在阻塞性睡眠呼吸暂停综合征中的变化及意义[J].南京医科大学学报(自然科学版),2008,28(3):380-383388