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目的评价阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的血管内皮功能。方法OSAHS患者30例(轻度组8例,中重度组22例)及对照组10例,分别用高分辨率超声检测基础状态、反应性充血时(内皮依赖性血管扩张)以及含服硝酸甘油后(非内皮依赖性血管扩张)的肱动脉内径,计算不同状态下肱动脉的扩张率以评估血管内皮功能。结果对照组、轻度和中重度OSAHS组患者反应性充血时肱动脉内径扩张率分别为(15.2±2.6)%、(14.3±3.2)%和(9.8±4.9)%,中重度OSAHS组患者血管内皮介导的舒张反应较对照组和轻度OSAHS组明显降低;含服硝酸甘油后肱动脉内径扩张率分别为(16.5±5.0)%、(15.7±4.1)%和(14.1±6.2)%,3组间无明显差别。结论中重度OSAHS患者存在血管内皮功能障碍,OSAHS本身可能是导致血管内皮损伤的重要因素。
Objective To evaluate the vascular endothelial function in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Thirty patients with OSAHS (8 in mild and 22 in moderate and severe group) and 10 in control group were enrolled in this study. High-resolution ultrasound was used to detect the basal state, reactive hyperemia (endothelium-dependent vasodilation) and nitroglycerin (Non endothelium-dependent vasodilation) brachial artery diameter, the rate of dilatation of the brachial artery at different states was calculated to evaluate the endothelial function. Results In the control group, the dilatation rates of brachial artery were (15.2 ± 2.6)%, (14.3 ± 3.2)% and (9.8 ± 4.9)% respectively in mild and moderate OSAHS group and those in moderate and severe OSAHS group Endothelium-mediated vasorelaxation was significantly decreased compared with the control group and mild OSAHS group. The brachial artery diameter expansion rates were (16.5 ± 5.0)%, (15.7 ± 4.1)% and (14.1 ± 6.2)%, respectively No significant difference between the 3 groups. Conclusion There are vascular endothelial dysfunction in patients with moderate-severe OSAHS. OSAHS itself may be an important factor leading to vascular endothelial injury.