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国家自然科学基金(81070072)

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Effects of Obstructive Sleep Apneas on Endothelial Function and Autonomic Modulation in Adult Man
2012年
Objective To study the effects of obstructive sleep apneas on endothelial function and autonomic modulation. Methods From June 2009 to June 2011, male patients with obstructive sleep apnea hypopnea syndrome (OSAHS) were consecutively enrolled in this study. Patients with an apnea/hypopnea index (AHI) of greater than 15 and without previous treatment for OSAHS were included as Group OSAHS and obese subjects with an AHI of less than 5 were included as non-OSAHS controls (Group Control). Electrocardiography and beat-to-beat blood pressure were continuously recorded from the radial artery by applanation tonometry which was synchronized with polysomnography recording. Endothelial function was measured by arterial augmentation index (AAI). Spectral analysis of heart rate variability (HRV) and blood pressure variability (BPV) were computed for cardiac parasympathetic modulation (high frequency power, HF); sympathetic modulation (low frequency power, LF), sympathovagal balance (LF/HF power of R-R variability, LF/HF) and BPV sympathetic modulation (BPV LF) in normalized units [total power of the components/(total power-very LF power)×100]. Results Finally, 27 moderate-severe OSAHS patients and 22 non-OSAHS obese controls were recruited in the Group OSAHS and Group Control, respectively. In Group OSAHS, the age was 43.3±9.3 year-old, body mass index (BMI) was 36.8±8.7 kg/m 2 ; in Group Control, the age was 42.9±8.6 year-old, BMI was 34.4±7.9 kg/m 2 ; there were no significant differences in age and BMI between the Group OSAHS and Group Control (all P>0.05). The baseline AAI (12.5%±2.2% vs. 8.2%±2.1%) and BPV LF (68.3%±13.5% vs. 61.1%±11.7%) of the Group OSAHS were significantly higher than those of the Group Control (all P<0.05). And after overnight sleep, systolic BP (143.7±14.2 vs. 132.8±13.3 mm Hg), diastolic BP (87.7±7.7 vs. 78.6±5.5 mm Hg), HRV LF (69.7%±14.4% vs. 64.3%±12.1%), HRV LF/HF (3.7±2.0 vs. 2.3±1.3) and BPV LF (77.8%±15.6% vs. 68.3%±13.5%) of the Group OSAHS were significantly increased (a
Xu ZhongYi XiaoRong Huang
关键词:睡眠呼吸暂停自主神经副交感神经功率谱分析
正确认识无创血管功能测定在睡眠呼吸暂停中的临床意义及其重要性被引量:4
2011年
OSAHS与心血管疾病关系密切,OSAHS引起的间歇低氧及反复微觉醒可导致血管结构性或功能性损害而最终促发心脑血管疾病.有学者发现目前检测方法对上述危险因素的阳性预测值仅为50%,而OSAHS患者行血管功能检测对预测其血管疾病的发生有重要意义,因此本文拟对无创血管功能的测定方法及其在OSAHS中的临床应用作一介绍.
钟旭肖毅
关键词:睡眠呼吸暂停OSAHS心血管疾病心脑血管疾病
持续气道正压通气治疗对阻塞性睡眠呼吸暂停低通气综合征患者血管内皮功能及自主神经调制的影响被引量:9
2012年
目的探讨即时及长期持续气道正压通气(continuous positive airway pressure,CPAP)治疗对于阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者血管内皮功能及自主神经调制的影响。方法共有23例呼吸暂停/低通气指数(apnea/hypopnea index,AHI)≥15次/h的OSAHS患者[AHI(58.8±28.4)次/h]纳入该研究。所有受试者均为男性,年龄为(43.2±10.7)岁,体质量指数为(33.7±8.3)kg/m2。该研究采用动脉增加指数(AAI)作为血管内皮功能的测量指标、心率变异(HRV)及血压变异(BPV)的各频谱成分作为自主神经调制的评价指标,对纳入研究的受试者接受整夜及长期(6个月)的CPAP治疗后其血管内皮功能及自主神经的变化进行评价。结果整夜CPAP治疗时:睡眠前后AAI、HRV及BPV各成分均无显著改变;与无CPAP治疗时相比,睡眠后的HRVLF(60.8±10.4vs69.8±13.8,P〈0.001)、HRV LF/HF(2.4±1.1vs3.8±1.8,P〈0.001)及BPVLF(66.5±11.6vs78.5±14.8,P〈0.001)有显著降低,HRVHF(29.5±11.7vs20.7±9.7,P〈0.05)有显著升高,而AAI无显著变化。6个月CPAP治疗后:与治疗前相比,睡眠前的AAI(8.1±1.8vs12.8±2.3,P〈0.001)显著降低,HRVLF(58.3±9.7vs63.4±11.5,P〈0.05)、HRVLF/HF(2.0±0.8vs2.5±1.2,P〈0.05)及BPVLF(60.5±12.1vs67.7±13.2,P〈0.05)显著降低,HRVHF(35.5±9.8vs28.8±10.1,P〈0.05)显著升高;但若停止CPAP治疗1个晚上,则晨起血压升高、自主神经功能紊乱仍会发生,但与6个月前未CPAP治疗时相比均有所减缓。结论整夜CPAP治疗除了可降低OSAHS患者的晨起血压升高,还可显著改善晨起自主神经紊乱,而长期有效CPAP治疗可显著改善基础内皮功能及自主神经调制,并可减缓OSAHS患者对阻塞性呼吸事件的�
钟旭肖毅黄蓉
关键词:阻塞性睡眠呼吸暂停低通气综合征持续气道正压通气治疗内皮功能
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