阻塞性睡眠呼吸暂停综合征合并高血压患者血浆神经肽Y水平变化

摘要

目的 探讨血浆神经肽Y(neuropeptide Y,NPY)在阻塞性睡眠呼吸暂停综合征(OSAS)引起血压增高中可能的作用.方法 采用放射免疫分析法检测417例(单纯OSAS患者113例、单纯高血压患者73例、OSAS合并高血压患者134例、无OSAS且血压正常对照97例)血浆NPY含量,比较4组间NPY水平并探讨NPY相关因素.结果 (1)NPY在4组的浓度分别为:正常对照组(50.5±37.2)pmol/L,单纯OSAS组(76.0±39.9)pmol/L,单纯EH组(66.9±36.2)pmol/L,OSAS合并EH组(86.8±36.8)pmol/L.OSAS患者无论是否合并高血压,血浆NPY水平均较正常对照者明显增高,OSAS合并高血压组NPY水平最高.(2)Pearson相关分析发现,非OSAS[呼吸暂停低通气指数(AHI)<10]人群中,NPY与平均SBP和DBP呈有意义相关.在OSAS(AHI≥10)人群中,NPY与平均SBP、体质指数,腹围、AHI和最低SaO_2与血浆NPY水平呈有意义相关.(3)多元线性回归结果显示,平均SBP受到腹围,AHI的影响,平均DBP的影响因素有颈围和体质指数,血浆NPY有统计学意义的影响因素为AHI和体质指数,且AHI对NPY水平影响较大.结论 血浆NPY水平可能参与了OSAS引起血压升高的病理生理过程,但是作用不大.%Objective To explore the potential role of neuropeptide Y (NPY) in the pathphysiological process of hypertension caused by obstructive sleep apnea sydrome (OSAS). Methods The concentration of serum NPY were measured with radioimmunoassay (RIA) in 417 subjects (97 normotensive controls without OSAS, 113 cases of normotensive with OSAS, 73 cases of hypertensive without OSAS and 134 cases of hypertensive with OSAS. Futher, the mean NPY level were compared in four groups and the possible effective factors on NPY were discussed. Results ( 1 ) The concentration of NPY in four groups were (50. 5 ±37. 2) pmol/L in normal controls, (76. 0 ±39. 9) pmol/L in normotensive with OSAS group, (66. 9 ± 36. 2 ) pmol/L in hypertensive without OSAS group and (86. 8 ± 36. 8 ) pmol/L in hypertensive with OSAS group. Whether the patients with OSAS combined with hypertension or not, the concentration of NPY in the serum raised remarkably compared with those without OSAS and hypertension,the highest level of serum NPY was detected in OSAS combined with hypertension group. (2) Pearson corelation analysis indicated that both SBP and DBP related to the serum NPY significantly in non-OSAS group (AHI < 10), while the BMI, abdominal circumference, AHI as well as the lowest level of SaO_2 correlated to NPY besides SBP in OSAS group with ( AHI ≥ 10). (3) Multiple linear regression model showed that the abdominal circumference and AHI were contributing factors to SBP, while neck circumference and BMI were contributing factors to DBP. The level of NPY in the serum were significantly affected by AHI and BMI, in which the former one had greater influnce. Conclusion The increased level of serum NPY may play weakly potential roles in the pathphysiological process of hypertension caused by OSAS.