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目的探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea syndrome,OSAHS)对高血压(hyper-tension,HT)患者血清巨噬细胞炎症蛋白-1α(macrophage inflammatory protein-1α,MIP-1α)和高敏C反应蛋白(high-sensitiv-ity c-reactive protein,hs-CRP)水平以及对心脏功能的影响。方法选取经多导睡眠监测仪确诊OSAHS患者、OSAHS合并高血压患者,及经心血管内科初诊原发性高血压患者共86例,分为OSAHS组29例、OSAHS+HT组30例和HT组27例,另设对照组(C组)30例,进行彩色多普勒超声心动图检查,测定血清MIP-1α、hs-CRP浓度。结果HT组、OSAHS+HT组收缩压、舒张压、脉压差均较OSAHS组显著升高(P<0.05)。OSAHS组、OSAHS+HT组、HT组E峰速度(E velocity,EV)均明显低于C组(P<0.05),且OSAHS+HT组、HT组与OSAHS组比较仍有统计学差异(P<0.05)。OSAHS组、OSAHS+HT组、HT组A峰速度(A velocity,AV)均较C组显著升高(P<0.05)。OSAHS+HT组血清MIP-1α水平显著高于HT组(P<0.05)。血清MIP-1α水平与A峰成负相关(r=-0.238,P=0.08),与E/A成正相关(r=0.307,P=0.02)。结论OSAHS能诱导患者血清MIP-1α水平改变,且较血清hs-CRP变化出现更早,如合并高血压病则更为明显;血清MIP-1α水平升高与心脏舒张功能降低相关。
Objective To investigate the effect of obstructive sleep apnea syndrome (OSAHS) on the expression of macrophage inflammatory protein-1α (MIP-1α) and High-sensitivity c-reactive protein (hs-CRP) levels and cardiac function. Methods Totally 86 OSAHS patients, OSAHS patients with hypertension and primary hypertension patients diagnosed by polysomnography were divided into OSAHS group (n = 29), OSAHS + HT group (n = 30) and HT group 27 cases, and another 30 cases of control group (C group), color Doppler echocardiography, serum MIP-1α, hs-CRP concentrations. Results The systolic blood pressure, diastolic blood pressure and pulse pressure difference in HT group and OSAHS + HT group were significantly higher than those in OSAHS group (P <0.05). OSAHS group, OSAHS + HT group and HT group were significantly lower than those in group C (P <0.05), and OSAHS + HT group and OSAHS group were still significantly different (P <0.05). OSAHS group, OSAHS + HT group and HT group A velocity (AV) were significantly higher than those in C group (P <0.05). The level of MIP-1α in OSAHS + HT group was significantly higher than that in HT group (P <0.05). The level of serum MIP-1α was negatively correlated with peak A (r = -0.238, P = 0.08) and positively correlated with E / A (r = 0.307, P = 0.02). Conclusions OSAHS can induce the change of serum MIP-1α level in patients with Hs-CRP, which is earlier than that of serum hs-CRP. It is more obvious if combined with hypertension. Serum MIP-1α level is associated with decreased diastolic function.