| Objective:Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a health problem that the morbidity and mortality inpatients with OSAHS are more and more increase. The incidence of OSAHS in majority male was 4%, the incidence of OSAHS in majority female was 2%. OSAHS is a relatively common and potentially life-threatening disorder characterized by repeated periodic closure of the pharyngeal airway during sleep time. During 7-hours, sleep, the occurrence of apnea are more 30 times, every-occurrence of apnea is more 10 seconds, the occurrence of apnea-hypopnea index are more 5 times. The epidemiologic investigation suggest that OSAHS has become an independent risk factor for unstable angina, myocardial infraction and brain infraction. It has been suggest that the incidence of cardiorascular disease and hypertension in OSAHS were 80% and 40%-46% respectively. Apnea, hypopnea, hypoxia and sleep disordered breathing occur frequently when patients with OSAHS sleep. So it is will cause blood pressure increase instantly. Finally hypertension will tack place. Furthermore we can not get effective planning for this kind of hypertension by drugs only. Endothlin-1 (ET-1) has been indicated that it is the most strong vasomotor in our bodies. There appear close relations between ET-1 and hypertension. But whether there are relations between ET-1 and patients with OSAHS and how close relations are not clear. Now we will investigate the influence of uvulopalatopharyngoplasty (UPPP) on ET-1 of patients with OSAHS and explore the role and clinical research of ET-1 in pathogenesis of hypertension in OSAHS patients. Methods:The levels of plasma ET-1 in 40OSAHS patients accompanied by hypertension, 10 normotensive OSAHS patients and 50 healthy controls were measured by ET-1 enzyme immunoassay Kit. Furthermore to measure the levels of plasma ET-1 in OSAHS patients after 3 months of therapy with UPPP. And analyze the relation between ET-1 and blood pressure body mass index (BMI), the lowest SaO2%, apnea hypopnea index(AHI). Results : The levels of plasma ET-1( x±s) were significantly higher in OSAHS patients accompanied by hypertension and normotensive OSAHS patients (123.91±23.44Pg/ml) and (92.22±13.17Pg/ml) respectively than those in the healthy controls (58.81±6.41Pg/ml) (p<0.01,respectively). In the two OSAHS groups , the levels of plasma ET-1 were significantly higher in OSAHS patients accompanied by hypertension than those in normotensive OSAHS patients (p<0.01). After 3 months of therapy with UPPP , the levels ofplasma ET-1 were no significantly difference among OSAHS patients accompanied by hypertension and normotensive OSAHS patients and the healthy controls (60.07±5.06Pg/ml) and (58.23±10.65Pg/ml) and (58.81±6.41Pg/ml) respectively. There were no significantly difference about the two OSAHS groups. The blood pressure levels of OSAHS patients accompanied by hypertension recover to normal level after therapy with UPPP. There were positive correlation between the concentration of ET-1 and the apnea hypopnea index (AHI) and blood pressure in all the 50 OSAHS patients with and without hypertension (r=0.468,p<0.01) (r=0.501,p<0.01) respectively. There were negative correlations between the concentration of ET-1 and the lowest oxygen desaturation in all the 50 OSAHS patients with and without hypertension (r=-0.436,p<0.01) There were no correlations between the concentration of ET-1 and the BMI in the 100 patients . Conclusion:The levels of plasma ET-1 in OSAHS patients with and without hypertension were significant higher than those in the healthy controls and through the treatment of UPPP, the levels of plasma ET-1recover to normal level,so did the blood pressure levels. There were correlations between ET-1 and polysomnography (PSG) parameters. There were not significant relations between ET-1 and BMI. It indicates that endothelial dysfunction might be involved in the levels of plasma ET-1 increasing. In all the result indicate that the elevation of ET-1 may contribute to hypertension and change of... |
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