Objective To investigate the correlation between serum level of visfatin and obesity in patients with obstructive sleep apnea hypopnea syndrome ( OSAHS) . Methods Forty-seven patients with OSAHS and 20 healthy controls were recruited in this study. Polysomnography was performed in all subjects to detect apnea-hypopnea index ( AHI) . The serumlevels of cisfatin, C-reactive protein ( CRP) , TNF-α, and IL-6 were measured by enzyme linked immunosorbent assay. The body mass inex ( BMI) was calculated.The level of cisfatin was compared between the OSAHS patients with different severity and the controls, and its relationship with the levels of AHI, BMI, CRP, TNF-α, and IL-6 was analyzed. Results The serumlevel of visfatin in the OSAHS patients was higher significantly than that in the controls ( P lt;0. 01) and increased by the severity of OSAHS. There were positive correlations between the serum level of visfatin and AHI,BMI, CRP, TNF-α, IL-6 in the OSAHS patients ( P lt;0. 05) . Conclusion The expression of visfatin may play an important role in the pathogenesis of OSAHS.
目的 总结多导睡眠监测的监测方法及护理要点。 方法 2010年3月－2011年3月采用美国伟康多导睡眠呼吸监测仪对睡眠中心78例患者进行不少于7 h的整夜连续监测和护理。 结果 76例患者顺利完成监测，确诊阻塞性睡眠呼吸暂停低通气综合征73例（重度17例，中度31例，轻度25例），单纯鼾症3例。1例因环境陌生、导联多无法入睡而监测失败，另1例因鼻气流导管脱落而监测失败。 结论 对症有效的护理方法是多导睡眠监测得以顺利完成的根本保证。
Objective To investigate the changes and clinical relationship of plasma adrenomedullin( ADM) , atrial natriuretic polypeptide( ANP) , and heart rate variability( HRV) in patients with obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods Seventy-five inpatients with OSAHS were enrolled in this study. According to the apnea hypopnea index ( AHI) by polysomnography, the subjects were divided into a mild group, a moderate group, and a severe group. Meanwhile, HRV was screened bydynamic electrocardiogram in sleep laboratory. HRV parameters were obtained including LF ( low frequency power) , HF( high frequency power) , pNN50( percentage of NN50 in the total number of N-N intervals) ,SDNN( standard deviation of the N-N intervals) , rMSSD( square root of the mean squared differences of successive N-N intervals ) . Plasma levels of ADM/ANP were measured by radioimmunoassay. Results The levels of SDNN ( P lt;0. 05) , rMSSD, pNN50, LF ( P lt; 0. 05) and HF were gradually reduced, and the levels of ADM ( P lt;0. 05) and ANP ( P lt; 0. 05) were increased with increasing severity of OSAHS. Linear correlation analysis demonstrated that SDNN was negatively correlated with ADM( r = - 0. 423, P lt;0. 05)and ANP( r = - 0. 452, P lt; 0. 05) , and LF was also negatively correlated with ADM( r = - 0. 348, P lt;0. 05) . Conclusion Lower HRV is associated with more sever OSAHS, and it may be modulated neurohumorally by ADM and ANP.
In recent years, more and more studies have shown that obstructive sleep apnea hypopnea syndrome (OSAHS) and metabolic syndrome are closely related and interact with each other, while hypertension, abnormal glucose metabolism, lipid metabolism disorders and obesity, as the main components of metabolic syndrome, have been further studied. Continuous positive airway pressure is currently the main treatment for OSAHS. This review focuses on the association between OSAHS and hypertension, glucose metabolism abnormalities, lipid metabolism disorders, obesity and the effects of treatment with positive airway pressure, aiming to provide a theoretical basis for the pathogenesis and treatment of OSAHS complicated with metabolic syndrome.
ObjectiveTo investigate the expression and significance of CD73 in rats with intermittent hypoxia and high fat diet.MethodsThe rat model of chronic intermittent hypoxia combined with high fat diet was established. Twenty-four healthy male Wistar rats in the SPF level were randomly divided into 4 group, with 6 rats in each group, namely group A (normoxia and normal diet), group B (normoxia and high fat diet), group C (intermittent hypoxia and normal diet)and group D (intermittent hypoxia and high-fat diet). After 6 weeks of experiment, the serum lipid levels, myocardial morphological changes under microscope, the expression level of CD73 protein detected byimmunohistochemistry and Western blot in myocardial cells in rats were compared among these groups.ResultsThe serum lipid levels were significantly different among these groups (P<0.05). HE results showed that the myocardial cells of group A had no obvious abnormalities; disorganized visible myocardial fibers with focal necrosis in groups B and C; myocardial cell injury was most obvious in group D, in which visible muscle fibers arranged in disorder, and grain was not clear, part of the muscle fibers were dissolved predominantly. Compared with group A, CD73 protein expression levels in myocardial cells in groups B, C, and D were significantly elevated (P<0.01). Furthermore, CD73 protein expression level in myocardial cells in group D was significantly higher than those in groups B and C (P<0.01). Western blot showed consistent results as immunohistochemistry: compared with group A, CD73 protein expression levels in groups B, C, and D were significantly elevated (P<0.05), and CD73 protein expression level in myocardial cells in group D was significantly higher than those in groups B and C (P<0.01).ConclusionChronic intermittent hypoxia and high fat diet can cause myocardial cell damage and upregulate CD73 expression in the cardiomyocytes.
Objective To explore the diagnosis and treatment of critically ill patients suffering from obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods Critically ill patients with OSAHS admitted in intensive care unit from January 2003 to December 2007 were retrospectively analyzed. Results Seventy-nine critically ill patients were diagnosed as OSAHS. The initial diagnosis of OSAHS was made by history requiring, physical examination, and Epworth sleepiness score evaluation. The final diagnosis was comfirmed by polysomnography thereafter. Base on the treatment of primary critical diseases, the patients were given respiratory support either with continuous positive airway pressure ( CPAP) or with bi-level positive airway pressure ventilation ( BiPAP) . Two cases died and the remaining 77 patients were cured anddischarged. Conclusions Timely diagnosis of OSAHS is important to rescue the critically ill patients. Respiratory support combined with treatment of primary critical diseases can improve the outcomes of these patients.
Objective To explore the difference between the hemorheology levels and the expression of hypoxia inducible factor 1α/2α (HIF-1α/2α) in the peripheral blood mononuclear cells of the Tibetan and Han patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods This research recruited 30 high-risk Tibetan and Han patients with OSAHS, and 30 Tibetan and Han healthy volunteers at the same period. The whole blood viscometer was used to detect the high shear rate of whole blood viscosity, low shear rate of whole blood viscosity, plasma viscosity ratio, red blood cell aggregation index, and hematocrit in each group. RT-qPCR and Western blot assays were used to detect the mRNA and protein levels of phosphoinositide 3-kinase (PI3K), serine/threonine kinase (AKT), nuclear factor-κB (NF-κB) p65, HIF-1α and HIF-2α in peripheral blood mononuclear cells. Results The hemorheology level of Tibetan OSAHS patients was significantly higher than that of healthy Tibetans and Han OSAHS patients (P<0.05), and the hemorheology level of Han OSAHS patients was significantly higher than that of Han healthy people (P<0.05) . The mRNA and protein levels of PI3K, AKT, NF-κB p65 and HIF-1α in the peripheral blood mononuclear cells of Tibetan OSAHS patients were significantly higher than those of the healthy Tibetans or Han people, and these indexes of the Han OSAHS patients were significantly higher than those of the Han healthy people (all P<0.05), while HIF-2α mRNA and protein levels were significantly lower than those of healthy Han people (all P<0.05). Conclusion The upregulation of HIF-1α level and downregulation of HIF-2α expression in peripheral blood mononuclear cells of OSAHS patients depend on the activation of the PI3K/AKT/NF-κB p65 signaling pathway, and the hemorheological level of Tibetan OSAHS patients is higher than that of Han OSAHS patients.
Objective To investigate the possible association between serum level of hepatocyte growth factor( HGF) and obstructive sleep apnea hypopnea syndrome( OSAHS) with hypertension.Methods 58 cases of OSAHS without hypertension, 61 cases of OSAHS with hypertension, and 50 normal controls were enrolled. Serum level of HGF was measured by enzyme-linked immunosorbent assay( ELISA) , and the relationships between the serum HGF level and blood pressure( BP) , apnea hypopnea index( AHI) , lowest SaO2 ( LSaO2 ) were analyzed by linear correlation analysis. Results The serum HGF level ( pg/mL) was 761. 46 ±60. 18, 970. 87 ±60. 94, and 487. 34 ±45. 52 in the OSAHS patients without hypertention, OSAHS patients with hypertention, and normal subjects, respectively. Which was significantly higher in the OSAHSpatients than the normal subjects, and highest in the OSAHS patients with hypertension( P lt; 0. 05) . The serum HGF level was positively related to AHI( r = 0. 452, P lt;0. 05) and negatively related to LSaO2 ( r =- 0. 328, P lt;0. 05) in the OSAHS patients without hypertention, positively related to AHI, SBP, DBP( r =0. 670, P lt;0. 01; r =0. 535, P lt;0. 05; r =0. 424, P lt;0. 05) and negatively related to LSaO2 ( r = - 0. 572,P lt;0. 01) in the OSAHS patients with hypertension. Conclusions SerumHGF level increases significantly in patients with OSAHS especialy in OSAHS patients with hypertension, and positively correlates with the severity of OSAHS and hypertension.
【摘要】 目的 探讨手术治疗鼻气道狭窄对阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome，OSAHS)患者的疗效。 方法 2008年2月-2010年2月，对300例OSAHS患者行鼻内镜鼻腔手术治疗，比较患者手术前后打鼾程度、嗜睡程度和鼾声评分。 结果 手术治疗鼻气道狭窄后患者嗜睡评分及鼾声评分平均值均小于术前，差异有统计学意义(Plt;0.05)，手术有效率88.67%，手术并发症发生率0.67%，为鼻中隔穿孔、鼻腔粘连。 结论 手术治疗鼻气道狭窄是治疗因鼻气道狭窄所致OSAHS的一种有效方法。【Abstract】 Objective To explore the therapeutic effect of the surgery of narrow nasal cavity on the obstructive sleep apnea hypopnea syndrome (OSAHS). Methods A total of 300 patients with OSAHS from February 2008 to February 2010 underwent the surgery of narrow nasal cavity and the pre- and post-operative Epworth sleepiness scale and snore scale were analyzed. Results After the surgery of narrow nasal cavity, snore degree, somnolence scale and snore scale decreased compared with those before the operation (Plt;0.05). The effective rate of the surgery was 88.67% and the rate of operative complication was 0.67%. Conclusion The surgery of narrow nasal cavity is effective for the patients with OSAHS caused by narrow nasal cauity.