Clinical Significance Of Determination Of ET-1,NO And EMPs In Patients Of Osahs Combined Hypertension

Background: Obstructive sleep apnea hypopnea syndrome(OSAHS)is the most common respiratory abnormalities and sleep-disorder disease in human beings,mainly characterized by night sleep snoring with apnea,and daytime sleepiness.OSAHS may lead to multiple organ dysfunction by repeated intermittent hypoxia and hypercapnia.Evidence is accumulating that OSAHS is independently associated with incidence and mortality of many cardiovascular diseases,including ischemic heart disease,heart failure,arrhythmia,and cerebrovascular diseases,especially hypertension.Epidemiological investigation shows that nearly 60% patients of OSAHS accompanied with hypertension and OSAHS is a major risk factor of hypertension,it is considered to be an independent factor which can cause hypertension besides age,obesity,smoking,hyperlipidemia and other factors.However,the mechanism of OSAHS combined with hypertension is still unclear.The study shows that the mechanism may be related to the sympathetic tension,peripheral vasoconstriction,the increase of renin-angiotensin-aldosterone activity,and the change of baroreceptor reflex.In recent years,endothelial dysfunction has been considered to play a key role in the pathophysiology of hypertension.However,there are few reports about whether endothelial dysfunction is also present in OSAHS combined with hypertension.Nitric Oxide(NO)is a biological activity factor which is synthesized and secreted by endothelial cells has an effect on vasodilatation.Studies have shown that when vascular endothelial dysfunction,NO synthesis is reduced and thus playing a role in the formation of hypertension.Endothelin-1(ET-1)is a vasoactive peptide that is secreted by endothelial cells,which causes vasoconstriction,stenosis of the vascular cavity and may lead to vascular sclerosis by enhancing peripheral resistance.It plays an important role in the development of hypertension.Endothelial microparticles(EMPs)is a product of endothelial cells activation or apoptosis.It carries a large amount of biological information during the production process,which can lead to dysfunction of vascular function.It is considered to be the most sensitive marker of the function of endothelial cells and plays an important role in the formation of cardiovascular diseases such as hypertension and coronary heart disease.The levels of NO,ET-1 and EMPs in peripheral blood of all subjects were detected in this study.We compare the differences of NO,ET-1 and EMPs levels between each group,and discuss the relationship between them and OSAHS with hypertension,and provide a new way of thinking for the early diagnosis and early treatment of OSAHS combined with hypertension.Objective: Detecting the levels of NO,ET-1 and EMPs in peripheral blood of all subjects to compare the differences of NO,ET-1 and EMPs between each group,and explore the relationship between them and OSAHS combined with hypertension,and clarify the mechanism of OSAHS with hypertension and provide a new way for clinical prevention and treatment.Methods: From January to December 2016,93 patients were diagnosed with OSAHS in the First Hospital of Jilin University,of which 40 cases of simple OSAHS patients(simple OSAHS),male / female(32 cases / 8 cases),age(54.5±7.8)years old,53 patients of OSHAS with hypertension(combined hypertension group),male / female(42cases /11 cases,age(54.4±7.1)years old).In the same period,30 healthy persons were used as control group,male / female(24/6),age(54.3±7.4)years old.NO was detected by colorimetric method,ET-1 was detected by double antibody sandwich method,and EMPs was detected by flow cytometry,respectively.Results: Compared with the control group,the level of ET-1 and EMPs in the simple OSAHS group and the combined hypertension group increased significantly(P<0.01),and the concentration of NO decreased(P<0.01).The level of ET-1 in the control group,the OSAHS group and the combined hypertension group increased in turn(F = 19.969,P<0.01),and the EMPs level increased in turn(F = 625.748,P< 0.01),while the NO level decrease in turn(F = 61.601,P<0.01);in the combined hypertension group,EMPs and ET-1 were positively correlated(r = 0.843,P< 0.05),but negatively correlated with NO(r = 0.934,P< 0.05);in simple OSAHS group,EMPs and ET-1 were positively correlated(r=0.789,P<0.05),and negatively correlated with NO(r=-0.899,P<0.05).Conclusion: The level of ET-1 and EMPs in peripheral blood of OSAHS patients with hypertension is significantly increased,while NO level is significantly decreased.Endothelial dysfunction in OSAHS patients with hypertension may be an important mechanism of OSAHS combined with hypertension.The detection of these three indicators will help to understand the endothelial function status of OSAHS patients and predict the occurrence of OSAHS combined with hypertension events.