CAJ | 학술논문

目的观察阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者外周血中缺氧诱导因子-1α(HIF-1α)与血管内皮生长因子(VEGF)的水平及其意义.方法对48例OSAHS合并心脑血管疾病患者、52例单纯OSAHS患者和100名体检正常者进行多导睡眠监测,采用酶联免疫吸附试验法对3组对象外周血中的HIF-1α、VEGF水平进行检测,外周血VEGF mRNA表达水平的测定采用逆转录-聚合酶链反应及计算机条带分析,并进行相关性分析.结果 ①@单纯OSAHS组与正常对照组血浆中HIF-1α、VEGF含量以及外周血单个核细胞VEGF mRNA的表达比较差异有统计学意义(P＜0.01).(b)OSAHS合并心脑血管病组与单纯OSAHS组血浆HIF-1α、VEGF含量以及外周血单个核细胞VEGFmRNA的表达比较差异有统计学意义(P＜0.01).②OSAHS患者血浆HIF-1α、VEGF水平以及VEGF mRNA的表达水平与睡眠呼吸紊乱指数、血氧饱和度小于90%的时间、晨起收缩压、晨起舒张压呈不同程度正相关,与最低血氧饱和度呈负相关.结论 HIF-1α在OSAHS患者外周血中的水平明显升高,主要通过调节VEGF的水平,并参与OSAHS的发病,并可能是OSAHS心血管并发症的重要发病机制之一.
목적 관찰조새성수면호흡잠정저통기종합정(OSAHS)환자외주혈중결양유도인자-1α(HIF-1α)여혈관내피생장인자(VEGF)적수평급기의의.방법 대48례OSAHS합병심뇌혈관질병환자、52례단순OSAHS환자화100명체검정상자진행다도수면감측,채용매련면역흡부시험법대3조대상외주혈중적HIF-1α、VEGF수평진행검측,외주혈VEGF mRNA표체수평적측정채용역전록-취합매련반응급계산궤조대분석,병진행상관성분석.결과 ①@단순OSAHS조여정상대조조혈장중HIF-1α、VEGF함량이급외주혈단개핵세포VEGF mRNA적표체비교차이유통계학의의(P＜0.01).(b)OSAHS합병심뇌혈관병조여단순OSAHS조혈장HIF-1α、VEGF함량이급외주혈단개핵세포VEGFmRNA적표체비교차이유통계학의의(P＜0.01).②OSAHS환자혈장HIF-1α、VEGF수평이급VEGF mRNA적표체수평여수면호흡문란지수、혈양포화도소우90%적시간、신기수축압、신기서장압정불동정도정상관,여최저혈양포화도정부상관.결론 HIF-1α재OSAHS환자외주혈중적수평명현승고,주요통과조절VEGF적수평,병삼여OSAHS적발병,병가능시OSAHS심혈관병발증적중요발병궤제지일.
Objective The aim of this study is to observe the change of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients, and to explore the relationship of VEGF, OSAHS and complicated cardiovascular cerebrovascular diseases. Methods Polysomnography (PSG) was used to conduct sleep apnea monitoring in 48 OSAHS complicated cardiovascular cerebrovascular diseases patients, 52 OSAHS patients and 100 healthy controls with normal physical examination, the level of HIF-1α and VEGF in plasma was measured by enzyme-linked immunosorbent assay. The expression of VEGF mRNA in peripheral blood mononuclear cells were examined by semi-quantitative reverse transcription-polymerase chain reaction analysis. Results ①(a)The level of HIF-1α and VEGF in plasma and the level of VEGF mRNA in peripheral blood mononuclear cells were significantly higher in simple OSAHS group than those in control group( P ＜ 0.01 ). (b)The level of HIF-1α and VEGF in plasma and the level of VEGF mRNA in peripheral blood mononuclear cells in OSAHS with complicated cardiovascular and cerebrovascular diseases group were higher than those in simple OSAHS group ( P ＜ 0. 01 ). ② There were different positive correlation between the levels of HIF-1α, VEGF in plasma, VEGF mRNA and AHI, T-SaO2 ＜ 90 ％, systdic blood pressure,diastolic blood pressur,there was a negative correlation between the levels of HIF-1α,VEGF in plasma, VEGF mRNA and min SaO2. Conclusions The level of HIF-1α in OSAHS were significantly increased, mainly through adjusting the level of VEGF, and these may participate in the pathogenesis of OSAHS, and may be the pathogenesis of OSAHS related complicated cardiovascular and cerebrovascular diseases.