中国医药
中國醫藥
중국의약
CHINA MEDICINE
2012年
10期
1225-1227
,共3页
肖淑萍%马英文%朱海英%孙红玉
肖淑萍%馬英文%硃海英%孫紅玉
초숙평%마영문%주해영%손홍옥
睡眠呼吸暂停,阻塞性%大电导钙激活钾通道%血管运动反应性
睡眠呼吸暫停,阻塞性%大電導鈣激活鉀通道%血管運動反應性
수면호흡잠정,조새성%대전도개격활갑통도%혈관운동반응성
Sleep apnea,obstructive%Large-conductance calcium-activated potassium channels%Vascular motor reactivity
目的 初步探讨阻塞性睡眠呼吸暂停低通气综合征患者(OSAHS)脑血管运动反应性及外周血白细胞大电导钙激活钾通道β1(BKcaβ1)亚单位表达的改变.方法 选OSAHS患者216例为OSAHS组,根据呼吸暂停低通气指数(AHI)和夜间最低血氧饱和度(LSaO2)将OSAHS组分为轻度(76例)、中度(87例)、重度(53例)OSAHS组；选择同期单纯性打鼾(AHI＜5次/h)的健康体检者65例作为健康对照组.通过过度换气、屏气及倾斜试验评价患者脑血管运动反应性和自动调节能力,并检测白细胞中BKCaβ1mRNA表达.结果 与健康对照组比较,中、重度OSAHS组患者低碳酸血症期、高碳酸血症期脑血管运动反应性降低,由卧位至立位平均动脉压和脑血流速度恢复90％所用时间增加,差异均有统计学意义(均P＜0.05)；中、重度OSAHS组卧位和立位的平均收缩压分别为(117 ±15)和(108 ±14)mm Hg(1 mm Hg=0.13 kPa),平均舒张压分别为(72±16)和(64±12)mm Hg,平均脑血流速度分别为(41±9)和(33±13)cm/s,不同体位间指标的差异均有统计学意义(均P＜0.05).健康对照组和中、重度OSAHS组的BKCaβ1mRNA表达值分别为1.13 ±0.41和0.63±0.38、0.48 ±0.29,中、重度OSAHS与健康对照组的差异有统计学意义(t值分别为7.838、9.588,P＜0.05),中、重度OSAHS组间差异有统计学意义(t=2.391,P＜0.05).脑血管运动反应性与BKcaβ1mRNA呈正相关,与血管的舒张能力关系较强(r=0.685,P＜0.05).结论 OSAHS患者尤其是中、重度患者脑血管运动反应性减弱,BKcaβ1mRNA表达降低,BKcaβ1导致了血管的功能失调.
目的 初步探討阻塞性睡眠呼吸暫停低通氣綜閤徵患者(OSAHS)腦血管運動反應性及外週血白細胞大電導鈣激活鉀通道β1(BKcaβ1)亞單位錶達的改變.方法 選OSAHS患者216例為OSAHS組,根據呼吸暫停低通氣指數(AHI)和夜間最低血氧飽和度(LSaO2)將OSAHS組分為輕度(76例)、中度(87例)、重度(53例)OSAHS組；選擇同期單純性打鼾(AHI＜5次/h)的健康體檢者65例作為健康對照組.通過過度換氣、屏氣及傾斜試驗評價患者腦血管運動反應性和自動調節能力,併檢測白細胞中BKCaβ1mRNA錶達.結果 與健康對照組比較,中、重度OSAHS組患者低碳痠血癥期、高碳痠血癥期腦血管運動反應性降低,由臥位至立位平均動脈壓和腦血流速度恢複90％所用時間增加,差異均有統計學意義(均P＜0.05)；中、重度OSAHS組臥位和立位的平均收縮壓分彆為(117 ±15)和(108 ±14)mm Hg(1 mm Hg=0.13 kPa),平均舒張壓分彆為(72±16)和(64±12)mm Hg,平均腦血流速度分彆為(41±9)和(33±13)cm/s,不同體位間指標的差異均有統計學意義(均P＜0.05).健康對照組和中、重度OSAHS組的BKCaβ1mRNA錶達值分彆為1.13 ±0.41和0.63±0.38、0.48 ±0.29,中、重度OSAHS與健康對照組的差異有統計學意義(t值分彆為7.838、9.588,P＜0.05),中、重度OSAHS組間差異有統計學意義(t=2.391,P＜0.05).腦血管運動反應性與BKcaβ1mRNA呈正相關,與血管的舒張能力關繫較彊(r=0.685,P＜0.05).結論 OSAHS患者尤其是中、重度患者腦血管運動反應性減弱,BKcaβ1mRNA錶達降低,BKcaβ1導緻瞭血管的功能失調.
목적 초보탐토조새성수면호흡잠정저통기종합정환자(OSAHS)뇌혈관운동반응성급외주혈백세포대전도개격활갑통도β1(BKcaβ1)아단위표체적개변.방법 선OSAHS환자216례위OSAHS조,근거호흡잠정저통기지수(AHI)화야간최저혈양포화도(LSaO2)장OSAHS조분위경도(76례)、중도(87례)、중도(53례)OSAHS조；선택동기단순성타한(AHI＜5차/h)적건강체검자65례작위건강대조조.통과과도환기、병기급경사시험평개환자뇌혈관운동반응성화자동조절능력,병검측백세포중BKCaβ1mRNA표체.결과 여건강대조조비교,중、중도OSAHS조환자저탄산혈증기、고탄산혈증기뇌혈관운동반응성강저,유와위지립위평균동맥압화뇌혈류속도회복90％소용시간증가,차이균유통계학의의(균P＜0.05)；중、중도OSAHS조와위화립위적평균수축압분별위(117 ±15)화(108 ±14)mm Hg(1 mm Hg=0.13 kPa),평균서장압분별위(72±16)화(64±12)mm Hg,평균뇌혈류속도분별위(41±9)화(33±13)cm/s,불동체위간지표적차이균유통계학의의(균P＜0.05).건강대조조화중、중도OSAHS조적BKCaβ1mRNA표체치분별위1.13 ±0.41화0.63±0.38、0.48 ±0.29,중、중도OSAHS여건강대조조적차이유통계학의의(t치분별위7.838、9.588,P＜0.05),중、중도OSAHS조간차이유통계학의의(t=2.391,P＜0.05).뇌혈관운동반응성여BKcaβ1mRNA정정상관,여혈관적서장능력관계교강(r=0.685,P＜0.05).결론 OSAHS환자우기시중、중도환자뇌혈관운동반응성감약,BKcaβ1mRNA표체강저,BKcaβ1도치료혈관적공능실조.
Objective To evaluate cerebral vasomotor reactivity and to investigate the expression changs of large-conductance Ca2+-activated k + channels β1(BKCaβ1)in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods Cerebrovascular reactivity was calculated by TCD-CO2 test(hypercapnia was induced by breath-holding and hypocapnia by hyperventilation)and squatting-to-tilt test; the change of BKCaβ1 in peripheral blood leukocytes was explored by reverse transcriptase-polymerase chain reaction(RT-PCR). Results Compared with healthy controls,vascular motor reactivity(VMR)decreased significantly in the severe and moderate OSAHS(P ＜ 0.05).The time from supine-to-tih position for the mean blood pressure and the cerebral blood flow velocity(CBFV)to return to ＞ 90％ of baseline levels was longer in the moderate and severe OSAHS(all P ＜ 0.05 );Bp and CBFV at tilt position decreased in the moderate and severe OSAHS(P ＜0.05).The expression of BKCaβ1mRNA in the moderate and severe OSAHS markedly reduced compared with that in healthy controls(0.63 ± 0.38and 0.48 ±0.29 vs 1.13 ±0.41,P ＜0.05).The extent of VMR was correlated positively to the level of BKCa β1mRNA.Conclusions Cerebral vascular motor reactivity is attenuated in OSAHS patient,especially in the moderate and severe groups.OSAHS down-regulates BKCaβ1 mRNA in peripheral blood leukocytes.BKCaβ1 can contribute to vascular dysfunction in severe OSAHS patient.
