The Study Of Serum Homocysteine In Elderly Patients With Obstructive Sleep Apnea/hypopnea Syndrome And Effect Of Auto-continuous Positive Airway Pressure Treatment On Serum Homocysteine

Objective To investigate the association between serum homocysteine(Hcy) levels and oxidative stress in elderly patients with obstructive sleep apnea/hypopnea syndrome(OSAHS).Methods Based on polysomnogram(PSG) and age, 83 patients were recruited and divided into an elderly OSAHS group(n=32) and a non-elderly OSAHS group(n=51). Fifty-two healty subjects were selected and divided into an elderly control group(n=29) and a non-elderly control group(n=23). All of the subjects were 135. All subjects were recorded PSG variables and the contents of Hcy,MDA and GSH were detected after sleep.Serum Hcy was measured by cyclophorase. MDA and GSH were measured by spectrophotometer.Results 1. There was statistical difference in Hcy concentrations in the four groups(P<0.05). The concentrations of Hcy in elderly OSAHS patients were higher than other groups.The concentrations in elderly control group were higher than those in non-elderly control;The concentrations in non-elderly OSAHS group were higher than those in non-elderly control. 2. There was statistical difference in MDA and GSH concentrations in the four groups(P<0.05). The concentrations of MDA in elderly OSAHS group were higher than other groups. GSH in elderly OSAHS group were higher than non-elderly OSAHS groups. MDA and GSH in elderly control group were higher than those in non-elderly control, non-elderly OSAHS group higher than non-elderly control. 3. Multielement linearity regression analysis indicated a statistically significant relationship between Hcy concentration and age(R~2=0.12), MDA (R~2=0.16), GSH (R~2=0.18) and AHI (R~2=0.21) .Conclusions 1. The concentrations of Hcy increased and oxidative stress enhanced with age. 2. The concentrations of Hcy increased and oxidative stress enhanced in the elderly patients with OSAHS. 3. The mechanism of high level of serum Hcy in elderly patients with OSAHS maybe was oxidative stress.Second part Comparison of Auto-continuous Positive Airway Pressure and Uvulopalatopharyngoplasty and Effect of the Former Treatment to Serum HomocysteineObjective To evaluate the effect of auto-continuous positive airways pressure (Auto-CPAP) and uvulopalatopharyngoplasty(UPPP) treatment for obstructive sleep apnea/hypopnea syndrome(OSAHS) and explore the influence of the former treatment to homocysteine (Hcy).Methods 83 patients were recruited who underwent a single-night polysomnogram (PSG) in our sleep-room and were diagnosed with OSAHS. 28 patients possessed indication and selected UPPP, 20 patients possessed indication and select Auto-CPAP. One year after treatment , polysomnography was repeated to determine the effect of UPPP and Auto-CPAP. The contents of Hcy,malonaldehyde(MDA) and glutathion(GSH) were detected after sleep. Serum Hcy was measured by cyclophorase, MDA and GSH were measured by spectrophotometer. Results 1. The total effective rate in UPPP group was 90%, better than Auto-CPAP group(χ~2=9.683,P<0.01). 2. The improvement of apnea hypopnea index(AHI)(19.82±12.74 )/h,minimum SaO2(-10.10±4.20)% in the treatment of Auto-CPAP was better than UPPP[(9.98±10.10)/h, (-6.54±5.54)%, P<0.05]. 3,The concentrations of Hcy, MDA and GSH in the patients with OSAHS decreased after the treatment of Auto-CPAP[(10.21±2.40)vs after(8.24±2.18)μmol/L, (6.21±1.56)vs after (3.85±0.74) nmol/mL, (6.21±2.20)vs after(4.53±1.22)mg/L, P<0.05].Conclusions 1. The efficacy of Auto-CPAP was better than UPPP in the patients with OSAHS. 2. The concentrations of Hcy,MDA and GSH decreased in the patients with OSAHS accepted Auto-CPAP.