The Clinical Study Of Endothelin(ET), Nitric Oxide(NO), Tumor Necrosis Factor-α(TNF-α) And Atrial Natriuretic Peptide (ANP) Levels In Blood Of OSAHS Patients With Hypertension

Objective To explore the changes of ET,NO,TNF-αand ANP in blood of patients with obstructive sleep apnea hypopnea syndrome(OSAHS)and obstructive sleep apnea associated hypertension.Methods Choose 16 cases of simple OSAHS patients,17 cases of OSAHS patients with hypertension and 12 cases of normal control group.Radioimmunoassay was used to detect the contents of ET,TNF-αand ANP,Cadmium reduction method was used to detecte the content of NO.Furthermore,linear correlations were performed between the biochemical parameters and sleep-breathing parameters of patients with OSAHS and OSAHS associated hypertension.Results 1.ET:Simple OSAHS group was(54.73±9.59)pg.ml^-1,OSAHS with hypertension was(59.65±10.59)pg.ml^-1,they were significantly higher than the control group of(42.43±12.75)pg.ml^-1P＜0.01);OSAHS with hypertension group was higher than simple OSAHS group(P＜0.05).2.NO:Simple OSAHS Group was(53.57±13.67)umol.l^-1,OSAHS with hypertension was(42.63±13.13)umol.l^-1,they were lower than the control group of (65.03±12.02)umol.l^-1(P＜0.05);OSAHS with hypertension group was lower than simple OSAHS group(P＜0.05).3.ET/NO:Simple OSAHS group was(1.13±0.48),OSAHS with hypertension group was(1.52±0.48),they were higher than the control group of(0.69±0.32)(P＜0.05);OSAHS with hypertension group was higher than simple OSAHS group(P＜0.05). 4.TNF-α:Simple OSAHS group was(2.60±0.95)ng.ml^-1,OSAHS with hypertension group was (3.11±0.50)ng.ml^-1,they were significantly higher than the control group of(1.78±0.56)ng.ml^-1 (P＜0.01);OSAHS with hypertension group was higher than simple OSAHS group(P＜0.05). 5.ANP:Simple OSAHS group was(235.77±52.06)pg.ml^-1,OSAHS with hypertension was (251.99±51.19)pg.ml^-1,they were significantly higher than the control group of(180.44±39.27) pg.ml^-1(P＜0.01);6.Sleep-breath monitoring indicators:(1)The apnea-hypopnea index(AHI): OSAHS with hypertension of(76.67±14.11)/h was higher than simple OSAHS group of(58.73±16.99)/h(P＜0.01);(2)Minimum SaO₂:OSAHS with hypertension of(50.59±17.01)%was lower than simple OSAHS group of(73.25±11.16)%(P＜0.01);(3)Below 90%oxygen saturation index:OSAHS with hypertension of(64.90±11.97)was higher than simple OSAHS group of(46.73±17.91)(P＜0.01);(4)The most prolonged times of breathing disorders:OSAHS with hypertension of(106.06±51.94)s was higher than simple OSAHS group(55.13±7.92)s(P＜0.01).7.(1)ET in Blood of OSAHS patients and OSAHS patients associated hypertension was positively correlated with AHI(r=0.558,P＜0.05;r=0.515,P＜0.05)and positively correlated with below 90%oxygen saturation index(r=0.584,P＜0.05;r=0.726,P＜0.01);(2) NO in Blood of OSAHS patients and OSAHS patients associated hypertension was negatively correlated with AHI(r=-0.596,P＜0.05;r=-0.498,P＜0.05)and negatively correlated with below 90%oxygen saturation index(r=-0.506,P＜0.05;r=-0.747,P＜0.01);(3)TNF-αin Blood of OSAHS patients and OSAHS patients associated hypertension was positively correlated with AHI(r=0.735,P＜0.01;r=0.514,P＜0.05)and positively correlated with below 90%oxygen saturation index(r=0.805,P＜0.01;r=0.617,P＜0.01).In short,compared simple OSAHS patients and OSAHS patients associated hypertension with the control group,ET,TNF-αand ET/NO ratio were increased,NO was reduced,they were correlated with the two serious conditions.ET,TNF-αand ET/NO ratio were increased in OSAHS patients with hypertension obviously.Conclusion OSAHS patients and OSAHS patients with hypertension have vascularendothelial injury and endothelial dysfunction.Endothelial injury and endothelial dysfunction increase vascular inflammation,promote the formation of atherosclerosis,may be involved in the merger and development of OSAHS patients with hypertension.