| Objectives (l)To investigate the levels of plasma carbon monoxide ( CO ) , nitric oxide (NO ) and indirect bilirubin (IDE) for purpose to appreciate their varieties in patients with obstructive sleep apnea hypoventilation syndrome(OSAHS) and finally explore the causes of higher morbidity of hypertension and atherosclerosis in patients with OSAHS. (2) To observe the changes of blood pressure in patients with OSAHS in order to investigate their complication of hypertension (HT) and relationships with the morbidity of OSAHS. Methods Polysomnography(PSG) was completed in 30 cases of controls and 111 persons with OSAHS . Blood samples were obtained and blood pressure were measured the next morning after recording PSG to detect plasma CO with the method introduced by Chalmers , NO by nitrate reductase method and IDE by improved J-G method . Among them, 20 cases of moderate to severe patients without any treatment were randomly treated with continuous airway positive pressure (CPAP) every night and their blood pressure were measured every morning in 30 days. Their plasma CO , NO and IDE were detected and compared52before , after an overnight ,and a month CPAP application. Linear relationship was analyzed between CO, NO and EDB. And multiple linear regression was performed with mean blood pressure (MBP), CO, NO and IDE as the dependent variables. Parameters included in the analysis were systolic blood pressure(SBP),diastolic bloodpressure(DBP),apnea-hypopnea index(AHI),body mass index(BMI) , lowest oxygen saturation(SaO2min), and age. Results (1) SBP and DBP in OSAHS were significantly higher than those of controls. And were the severe than the mild and moderate. And the morning's blood pressure in patients accompanied with HT were also significantly higher than those before sleep.The morbidity of hypertension in 111 cases of OSAHS was 50.5%.The morbidity of mild , moderate and severe OSAHS were 26%, 37% and 61% , respectively .Blood pressure significantly decreased after a month CPAP application. Multiple regression analysis indicated that MBP in OSAHS were significantly correlated with age ( r=0.41, P<0.05 ) and SaO2min ( r=-0.41,P<0.05 ). (2)Plasma CO levels in OSAHS were significantly higher than those in controls(0.75?.13 VS 0.50 ?0.10 mg/L, P<0.05). And were the severe than those in the mild (0.81 ?.15 VS 0.68+0.12 mg/L , P<0.05). And Plasma CO in OSAHS accompanied with HT were also53significantly higher than those without HT (0.78 + 0.15 VS 0.72 + 0.12 mg/L,P<0.05). (3) Plasma NO levels in OSAHS were significantly higher than those in controls(59 ?3 VS 45 + 8 u mol/L, P<0.05). And were the severe than those in the mild (62+15 VS 55 +11 u mol/L, P<0.05).Moreover, plasma NO in OSAHS accompanied with HT were markedly higher than those without HT (63 +15 VS 57 ?13 u mol/L, P<0.05) . But there was no remarkable difference of NO between mild and moderate OSAHS(55 +11 VS 57+13 u mol/L , P>0.05).(4)Plasma IDB levels in controls were significantly higher than those in OSAHS(16 + 5.0 VS 11 +3.5 u mol/L, P<0.05). And were the mild than those in the severe (12 + 3.5 VS 10 + 3.0 u mol/L ,P<0.05). Moreover, plasma IDB in OSAHS without HT were also markedly higher than those accompanied with HT(13+4.0 VS 9.6+ 3.On mol/L, P<0.05). (5)There were few changes of plasma CO , NO and IDB in 20 men with OSAHS after an overnight CPAP application(0.78 + 0.30 VS 0.79 + 0.3 Img/L , P>0.05; 52+13 VS 53 + 12u mol/L, P>0.05; 9.5 + 5.0 VS 8 + 3.5 u mol/L, P>0.05),but significant decrease of CO and NO(0.53 + 0.20 VS 0.79 + 0.31mg/L,P<0.05;47 + 8 VS 53 + 12 u mol/L, P<0.05) and significant increase of IDB (14?5.0 VS 8 + 3.5 u mol/L , P<0.05) after a month CPAP use. (6) Multiple regression54analysis indicated that plasma CO levels were significantly correlated with AMI (r=0.32,P<0.05), DBP (r=0.23,P<0.05), and SaO2min (r=-0.32, P<0.05). And Plasma NO levels were also significantly correlated with SaOimin (r=-0.31, P<0.05). Plasma IDE levels in OSAHS were significantly correlate...
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