Expression And Clinical Significance Of Vascular Endothelial Growth Factor-A And Insulin-like Growth Factor-2 In Patients With Hypertension Complicated With Obstructive Sleepapnea Hypopnea Syndrome

Objective: To investigate the blood pressure and levels of plasma vascular endothelial growth factor-A(VEGF-A)and insulin-like growth factor-2(IGF-2)in hypertension patients with obstructive sleep apnea hypopnea syndrome(OSAHS)to explore the clinical significance.Methods: A total of 76 patients were enrolled and divided to three groups: Patients with hypertension alone(A group,n=25);Patients with hypertension complicated with mild or moderate OSAHS(B group,n=25);Patients with hypertension complicated with severe OSAHS(C group,n=26).The clinical data and results of polysomnography,cardiac color Doppler ultrasound and dynamic blood pressure were collected,and plasma VEGF-A and IGF-2 levels were measured by ELISA.Results: Compared with the group A,the plasma VEGF-A levels in the group B and C increased significantly[(133.04±14.82)pg/ml,(183.47±15.10)pg/ml,(224.75±28.72)pg/ml,P<0.05],and the IGF-2 levelwere also significantly higher[(319.93±32.85)ng/ml,(380.49±28.98)ng/ml,(396.28±29.01)ng/ml,P<0.05].The left atrium diameter and the left ventricle posterior wall thickness in group C were much higher than those in group A.Compared with group A,nocturnal and 24-hour mean diastolic blood pressure(DBP)increased significantly in group B,the nocturnal and24-hour mean systolic blood pressure and DBP,daytime mean DBP were also higher in group C.The differences were all statistically significant(P<0.05).The levels of VEGF-A and IGF-2 of patients in group B and C were positively correlated with apnea hypopnea index,and level of VEGF-A was negatively correlated with the average pulse oxygen saturation during sleep.In three groups,VEGF-A and IGF-2 levels were positively correlated with blood pressure.And there were a positive correlation between the levels of plasma VEGF-A and IGF-2.Conclusion: The plasma VEGF-A and IGF-2 levels of hypertension patients who were combined with OSAHS were significantly higher than those with hypertension alone,which might be related to the difficulty of blood pressure control in these hypertension patients combined with OSAHS.The blood pressure of patients with hypertension combined with OSAHS was further increased than that of patients with simple hypertension,and the increase of blood pressure,left atrial enlargement and the left ventricular posterior wall hypertrophy were more obvious in patients with severe OSAHS.