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目的通过检测阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清血管内皮生长因子(VEGF)质量浓度,探讨其与肺动脉高压的关系。方法选择2003-02~2004-09温州医学院附属第一医院收治的93例因打鼾就诊的患者,对18例单纯鼾症、39例轻中度及36例重度OSAHS患者于多导睡眠图(PSG)检测后次日晨7:00测定其血清VEGF质量浓度,并予超声心动图检测了其中31例OSAHS患者肺动脉压力。结果PSG检测结果显示与单纯鼾症组比,OSAHS组存在夜间低氧;且重度组比轻中度OSAHS组夜间低氧更严重(均有统计学意义)。与单纯鼾症组比较,VEGF质量浓度在重度OSAHS组中明显升高(P<0·05),并分别与衡量病情及夜间低氧情况指标呈正相关,与夜间最低经皮血氧饱和度(SpO2)呈负相关。结论中重度OSAHS患者存在夜间低氧饱和度,同时有VEGF增高。
Objective To investigate the relationship between the level of vascular endothelial growth factor (VEGF) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and pulmonary hypertension. Methods Ninety-three patients admitted to the First Affiliated Hospital of Wenzhou Medical College from February 2003 to September 2004 were enrolled in this study. 18 patients with simple snoring, 39 mild to moderate and 36 severe OSAHS patients underwent polysomnography PSG) at 7:00 the next morning to determine the serum concentration of VEGF, and to echocardiography in which 31 cases of OSAHS patients with pulmonary artery pressure. Results PSG results showed that night hypoxemia was observed in OSAHS group compared with simple snoring group, and nighttime hypoxia was more severe in OSAHS group than in mild OSAHS group (all statistically significant). Compared with simple snoring group, VEGF concentration was significantly increased in severe OSAHS group (P <0.05), and were positively correlated with the severity of the disease and nighttime hypoxia, respectively, with the lowest percutaneous oxygen saturation at night SpO2) was negatively correlated. Conclusions Patients with moderate-severe OSAHS have nocturnal hypoxemia and elevated VEGF.