高血压伴OSAHS患者血AT1受体自身抗体水平与呼吸暂停低通气指数的关系

目的探讨高血压伴阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者抗血管紧张素1受体(AT1)自身抗体水平与呼吸暂停低通气指数(AHI)的关系.方法选取200例高血压伴OSAHS患者为研究对象,纳入研究组,以同期确诊的单纯OSAHS患者100例为对照组,对比两组收缩压(SBP)、舒张压(DBP)、AHI等基线资料,比较轻、中、重度OSAHS患者SBP,DBP水平,分析高血压伴OSAHS患者SBP,DBP与AHI的相关性,同时对比两组血浆AT1自身抗体、内皮素(ET-1)、内源性一氧化氮(NO)水平,分析AT1自身抗体与SBP,DBP,AHI,ET-1,NO的相关性.结果研究组体质量指数、颈围、腰围、SBP、DBP、AHI均较单纯SAHS组高(P0.05);随病病情程度加重,研究组SBP,DBP均显著增加,且研究组SBP,DBP显著高于对照组(P0.05);高血压伴OSAHS患者SBP,DBP与AHI呈正相关(P0.05);研究组AT1自身抗体、ET-1较对照组高,研究组NO水平与对照组比较明显低(P0.05);相关分析显示:AT1自身抗体水平与SBP,DBP,AHI,ET-1呈正相关,而与NO水平呈负相关(P0.05).结论高血压伴OSAHS患者血AT1受体的肾素-血管紧张素系统可能参与了OSAHS合并高血压的病变过程.

Relationship between Serum AT1 Receptor Autoantibodies Level and Apnea Hypopnea Index in Patients with Hypertension and OSAHS

Objective To investigate the relationship between the levels of angiotensin 1 receptor ( AT1 ) autoantibodies and apnea hypopnea index ( AHI ) in patients with hypertension and obstructive sleep apnea hypopnea syndrome ( OSAHS) . Method A total of 200 patients with hypertension and OSAHS were selected as the study group. Another 100 patients with simple OSAHS diagnosed in the same period were selected as the control group. The systolic blood pressure ( SBP) ,diastolic pressure ( DBP) ,AHI and other baseline datum were compared between the two groups. SBP and DBP of the patients with mild,moderate and severe OSAHS were compared. Correlation between SBP,DBP and AHIin patients with hypertension and OSAHS was analyzed. The levels of plasma AT1 autoantibodies,endothelin ( ET-1) and endogenous nitric oxide ( NO) were also compared between the two groups. And the correlation between AT1 autoantibodies and SBP,DBP,AHI,ET-1 and NO was analyzed. Results The body mass index (BMI),neck circumference,waist circumference,SBP,DBP and AHI of the study group were higher than those of the control group(P<0. 05). With the aggravation of the disease, SBP and DBP of the study group increased significantly,and were significantly higher than those of the control group ( P<0. 05 ) . SBP and DBP were positively correlated with AHI in the patients with hypertension and OSAHS (P<0. 05). Compared with the control group,AT1 autoantibodies and ET-1 levels of the study group were much higher,while NO level was significantly lower (P<0. 05). Correlation analysis showed that the levels of AT1 autoantibodies were positively correlated with SBP,DBP,AHI and ET-1,but negatively correlated with NO ( P<0. 05) . Conclusion The levels of AT1 receptor autoantibodies are positively correlated with AHI and ET-1,and negtively correlated with NO in the patients with hypertension and OSAHS. The renin-angiotensin system with AT1 may be involved in the pathological process of OSAHS with hypertension.