老年高血压病并发OSAS患者机体炎症反应与氧化应激因子水平的研究

摘要

[目的]探讨老年高血压病并发阻塞性睡眠呼吸暂停综合征(OSAS)患者机体炎症反应与氧化应激因子水平的关系.[方法]选择80例年龄大于60岁的患者,根据诊所血压、24 h动态血压和多导睡眠图监测结果分为单纯高血压病组30 例(A组)和高血压病并发OSAS组50例(B组).B组其中轻度OSAS患者25例(B1组)和中重度OSAS 25例(B2组).检测并比较各组白细胞介素(IL-8)及可溶性细胞间黏附分子1 ( ICAM-1)的表达水平和细胞内的CXCR2(单核细胞上的IL-8受体)及NOX2(还原型辅酶Ⅱ氧化酶核心酶)的mRNA表达水平.[结果]B2组血浆中IL-8及ICAM-1表达水平显著高于A组和B1组(P<0.05);A组单个核细胞内的CXCR2及NOX2 mRNA定量表达水平显著低于B1组和B2组(P<0.05),B2组单个核细胞内的CXCR2及NOX2 mRNA定量表达水平显著高于B1组(P<0.05).[结论]老年单纯高血压与合并OSAS组患者血压、血脂及血糖水平无明显差异,合并OSAS组高血压患者体内炎症与氧化应激因子表达水平明显增加,尤其是在中重度OSAS组的患者,提示较单纯高血压,合并OSAS的老年高血压病患者在将来发生心血管系统并发症的几率可能会增加.%[Objective]To explore the relationship between body inflammatory reaction and the level of oxidative stress factors in elderly hypertensive patients with obstructive sleep apnea syndrome(OSAS).[Methods]Sixty patients aged over 60 years old were chosen.According to the results of clinic blood pressure, 24h ambulatory blood pressure(ABP) and polysomnography(PSG), all these patients were divided into simple hypertension group(group A, n =30) and hypertension with OSAS group(group B, n =50) which were subdivided into mild OSAS group(group B1, n =25) and moderate/severe OSAS group(group B2, n =25).Serum levels of interleukin-8(IL-8), intercellular adhesive molecule(ICAM-1), mRNA of CXCR2(receptor of IL-8 in monocytes) and NOX2(the key oxidation enzyme of NADPH) in three groups were measured.[Results]The expression level of IL 8 and ICAM-1 in group B2 were significantly higher than those in group A and B1( P ＜ 0.05).The qualitative expression level of CXCR2 and NOX2 mRNA in group A were significantly lower than those in group B2 and B1( P ＜0.05).The qualitative expression level of CXCR2 and NOX2 mRNA in group B2 were significantly higher than those in group B1 (P ＜0.05).[Conclusion]Although there is no obvious difference in blood pressure, blood sugar and blood lipid between elderly simple hypertensive patients with and without OSAS, the inflammation and oxidative stress factors in hypertensive patients with OSAS, especially moderate and severe OSAS patients, increase significantly.It indicates that the incidence of the complications in cardiovascular system in elderly hypertensive patients with OSAS will increase in the future compared with simple hypertensive patients.