目的 探讨自动调节持续气道正压通气(auto-CPAP)治疗对OSAHS患者血管内皮功能紊乱的影响.方法 对确诊为OSAHS的实验组进行三个月auto-CPAP治疗,分别测定三个月前后两组血清及EBC中ET-1及NO水平,以及颈动脉内膜中层厚度(IMT).结果 实验组血清和EBC中ET-1水平以及EBC中NO水平均明显下降,IMT较前减少.血清和EBC中ET-1及NO水平与AHI等睡眠监测指标存在相关性.结论 EBC中ET-1及NO水平检测可了解OSAHS患者血管内皮功能紊乱,这种异常可以通过auto-CPAP治疗改善.%Objective To investigate the effect of auto-CPAP therapy on disturbance of vascular endothelium in patients with obstructive sleep apnea/ hypoventilation syndrome( OSAHS ) and the clinical significance of testing Endothelin-1 and Nitric Oxide in exhaled breath condensate( EBC ) of patients with OSAHS. Methods 42 patients with moderate-to-severe OSAHS were randomly allocated to the active group. The active group received the treatments of three months' auto-CPAP. Endothelin-1 and Nitric Oxide levels in plasma and EBC were measured before and after 3 months. Philips iU22 color doppler ultrasound instrument was used to measure intima-medial thick-ness( IMT) of jugular arteries. Results Between before treatment and after the three months, there were significant decrease inAHI, Endothelin-1 levels in plasma and EBC in the active group, and Nitric Oxide levels in EBC were lower. Endothelin-1 levels and Nitric Oxide levels in plasma and EBC were correlated with AHI, LSpO2 , MSpO2 and IMT, but Nitric Oxide levels in EBC showed no correlation with IMT. Conclusion The disturbance of vascular endothelium in patients with OSAHS can be evaluated by testing Endothelin-1 and Nitric Oxide in their EBC, which can be improved by the auto-CPAP treatment.
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