中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2010年
3期
257-260
,共4页
阻塞性睡眠呼吸暂停低通气综合征%RhoA%Rho相关激酶-2%肺动脉高压
阻塞性睡眠呼吸暫停低通氣綜閤徵%RhoA%Rho相關激酶-2%肺動脈高壓
조새성수면호흡잠정저통기종합정%RhoA%Rho상관격매-2%폐동맥고압
Obstructive sleep apnea-hypopnea syndrome%RhoA%Rho associated kinase-2%Pulmona-ry hypertension
目的 探讨RhoA/ROCK-2在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者肺动脉高压(PH)形成中的作用.方法 选择经全夜多导睡眠监测确诊的30例OSAHS患者作为实验组,同时选择与之性别、年龄、体重指数(BMI)相匹配的健康志愿者15名作为对照组;行彩色多普勒超声心动图测定肺动脉压力(PAP);检测血清RhoA/ROCK-2含量.结果 OSAHS组PAP水平[OSAHS患者合并PH组为(47.30±12.85)mm Hg、OSAHS患者未合并PH组为(22.31±3.07)mm Hg]高于对照组[(19.47±1.92)mm Hg],差异有统计学意义(W=175.50,P<0.05);OSAHS未合并PH者血清RhoA和ROCK-2水平[分别为(10.43±3.10)、(22.31±16.10)μg/L]明显高于对照组[(2.94±1.20)、(6.04±0.28)μg/L],差异有统计学意义(W=120.00,W=121.00,P均<0.05);OSAHS未合并PH者血清RhoA/ROCK-2水平低于OSAHS合并PH者[(14.85±8.49)、(36.81±12.69)μg/L],但仍高于对照组,差异有统计学意义(H=29.172,H=30.242,P均<0.05);相关分析显示OSAHS组无论是合并PH还是未合并PH,PAP和睡眠呼吸暂停低通气指数均呈正相关(r_s=0.793,r_s=0.887,P均<0.05),最低动脉血氧饱和度和PAP呈负相关(r_s=-0.562,r_s=-0.751,P均<0.05),血清RhoA/ROCK-2水平均与PAP呈正相关(r_s=0.793,r_s=0.887,P均<0.05),RhoA和ROCK-2水平亦呈正相关(r_s=1.000,r_s=1.000,P均<0.05).结论 OSAHS为肺动脉高压发生的独立危险因素,并且RhoA/ROCK-2通路可能在OSAHS患者肺动脉高压的形成中起重要作用.
目的 探討RhoA/ROCK-2在阻塞性睡眠呼吸暫停低通氣綜閤徵(OSAHS)患者肺動脈高壓(PH)形成中的作用.方法 選擇經全夜多導睡眠鑑測確診的30例OSAHS患者作為實驗組,同時選擇與之性彆、年齡、體重指數(BMI)相匹配的健康誌願者15名作為對照組;行綵色多普勒超聲心動圖測定肺動脈壓力(PAP);檢測血清RhoA/ROCK-2含量.結果 OSAHS組PAP水平[OSAHS患者閤併PH組為(47.30±12.85)mm Hg、OSAHS患者未閤併PH組為(22.31±3.07)mm Hg]高于對照組[(19.47±1.92)mm Hg],差異有統計學意義(W=175.50,P<0.05);OSAHS未閤併PH者血清RhoA和ROCK-2水平[分彆為(10.43±3.10)、(22.31±16.10)μg/L]明顯高于對照組[(2.94±1.20)、(6.04±0.28)μg/L],差異有統計學意義(W=120.00,W=121.00,P均<0.05);OSAHS未閤併PH者血清RhoA/ROCK-2水平低于OSAHS閤併PH者[(14.85±8.49)、(36.81±12.69)μg/L],但仍高于對照組,差異有統計學意義(H=29.172,H=30.242,P均<0.05);相關分析顯示OSAHS組無論是閤併PH還是未閤併PH,PAP和睡眠呼吸暫停低通氣指數均呈正相關(r_s=0.793,r_s=0.887,P均<0.05),最低動脈血氧飽和度和PAP呈負相關(r_s=-0.562,r_s=-0.751,P均<0.05),血清RhoA/ROCK-2水平均與PAP呈正相關(r_s=0.793,r_s=0.887,P均<0.05),RhoA和ROCK-2水平亦呈正相關(r_s=1.000,r_s=1.000,P均<0.05).結論 OSAHS為肺動脈高壓髮生的獨立危險因素,併且RhoA/ROCK-2通路可能在OSAHS患者肺動脈高壓的形成中起重要作用.
목적 탐토RhoA/ROCK-2재조새성수면호흡잠정저통기종합정(OSAHS)환자폐동맥고압(PH)형성중적작용.방법 선택경전야다도수면감측학진적30례OSAHS환자작위실험조,동시선택여지성별、년령、체중지수(BMI)상필배적건강지원자15명작위대조조;행채색다보륵초성심동도측정폐동맥압력(PAP);검측혈청RhoA/ROCK-2함량.결과 OSAHS조PAP수평[OSAHS환자합병PH조위(47.30±12.85)mm Hg、OSAHS환자미합병PH조위(22.31±3.07)mm Hg]고우대조조[(19.47±1.92)mm Hg],차이유통계학의의(W=175.50,P<0.05);OSAHS미합병PH자혈청RhoA화ROCK-2수평[분별위(10.43±3.10)、(22.31±16.10)μg/L]명현고우대조조[(2.94±1.20)、(6.04±0.28)μg/L],차이유통계학의의(W=120.00,W=121.00,P균<0.05);OSAHS미합병PH자혈청RhoA/ROCK-2수평저우OSAHS합병PH자[(14.85±8.49)、(36.81±12.69)μg/L],단잉고우대조조,차이유통계학의의(H=29.172,H=30.242,P균<0.05);상관분석현시OSAHS조무론시합병PH환시미합병PH,PAP화수면호흡잠정저통기지수균정정상관(r_s=0.793,r_s=0.887,P균<0.05),최저동맥혈양포화도화PAP정부상관(r_s=-0.562,r_s=-0.751,P균<0.05),혈청RhoA/ROCK-2수평균여PAP정정상관(r_s=0.793,r_s=0.887,P균<0.05),RhoA화ROCK-2수평역정정상관(r_s=1.000,r_s=1.000,P균<0.05).결론 OSAHS위폐동맥고압발생적독립위험인소,병차RhoA/ROCK-2통로가능재OSAHS환자폐동맥고압적형성중기중요작용.
Objective To investigate the role of RhoA/Rho associated kinase-2 (RhoA/ROCK-2) in the development of pulmonary hypertension (PH) in patients with obstructive sleep apnea-hypopnea syndrome (OS-AHS). Methods Thirty patients diagnosed as OSAHS by polysomnograshy(PSG) test in our sleep laberatoty were recruited as the observation group, and fifteen healthy subjects matched in gender, age and body mass index (BMI) were recruited as the controls. Pulmonary arterial pressure was measured by echocardiography. Serum RhoA/ROCK-2 levels were measured. Results The level of PAP was (47.30±12.85)mm Hg in OSAHA patients complicated with PH, (22.31±3.07)mm Hg in OSAHA patients without PH, which were significantly higher than that in the controls (19.47±1.92) mm Hg (W=175.50, P < 0.05). The serum RhoA and ROCK-2 in OSAHA patients with-out PH (10.43±3.10 and 22.31±16.10 μ/L, respectively) were significantly higher those in the controls (2.94±1.20)μg/L and (6.04±0.28)μg/L, respectively) (W=120.00, W= 121.00, respectively, P<0.05), whereas significantly lower than that in OSAHA patients complicated with PH(14.85±8.49)μg/L, (36.81±12.69) μg/L, respectively) (H =29.172, H =30.242, respectively, P <0.05). There was a positive correlation between PAP and AHI in patients with OSAHS, whether complicated with PH or not(r_s=0.793, r_s=0.887,P <0.05), and there was a negative correlation between PAP and LSaO2 in patients with OSAHS (r_s=-0. 562,r_s = -0.751, P <0.05). There were positive correlations between the level of RboA/ROCK-2 and PAP in patients with OSAHS(r_s = 0.793,r_s = 0.887,P < 0.05). Finally, there was a positive correlation between the level of RhoA and ROCK-2 in patients with OSAHS (r_s = 1.000,r_s = 1.000,P < 0.05). Conclusions OSAHS is an inde-pendent risk factor for pulmonary hypertension. The levels of serum RhoA/ROCK-2 in OSAHS patients with PH were increased in the development of the disease. It may play an important role in the process of pulmonary hyper-tension in patients with OSAHS.
