Objective To investigate the implication of oxidation protein product ( advanced oxidation protein product, AOPP) , an index of oxidative stress in obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods 47 patients with OSAHS and 48 normal controls were enrolled. The concentration of AOPP was measured by spextrophotometry after ameliorated, while superoxide ( SOD) , malonaldehyde ( MDA) , glutathione peroxidase ( GSH-PX) in morning blood samples were detected by Xanthine oxidase test. Results ( 1) Plasma AOPP and MDA were significantly elevated in OSAHS compared with those in control group ( both P lt;0. 01) . Plasma SOD and GSH-PX were significantly lower in OSAHS compared with those in control group ( both P lt;0. 01) . There were significant differences in the plasma AOPP, MDA, SODand GSH-PX among different severity of OSAHS ( all P lt; 0. 01) . Plasma AOPP and MDA were increased and SOD and GSH-PX were gradually decreased with the progression of OSAHS. ( 2) Plasma AOPP correlated well with MDA, SOD and GSH-PX, moreover, AOPP was positively correlated with apnea hyponea index or lowest oxygen saturation. Conclusion AOPP is an alternative index reflecting both oxidative streess and tissue injury in patients with OSAHS.
【Abstract】 Objective To study the effects of obstructive sleep apnea hypopnea syndrome ( OSAHS) on blood pressure variations, and explore the possible mechanism. Methods 84 adult patients ( mean age 50. 1 ±14. 8 years, male /female 67 /17) were recruited for polysomnography ( PSG) and ambulatory blood pressure monitoring. Four groups were identified based on apnea hyponea index ( AHI) ,ie. non-OSAHS group ( n=9) ,mild group ( n=19) , moderate group ( n=23) , and severe group ( n =33) .The blood pressure levels were compared among the four groups. Correlations between PSG indexes,variations of systolic blood pressure ( SBP) and diastolic blood pressure ( DBP) were analyzed. Results Inter-group blood pressure comparison showed significant differences in SBP and DBP( P lt;0. 05) , except forthe mild and the moderate OSAHS patients. As compared with the non-OSAHS patients, SBP for those with severe OSAHS was about 15 mm Hg higher, and DBP 10 mm Hg higher. Observation on SBP non-dipping rate indicated that, except for the mild and the moderate OSAHS patients where no significant differences were found, SBP non-dipping rate increased with the severity of OSAHS( the rates were 78. 3%, 57. 1% ,54. 5%, and 32. 6% , respectively for the four groups) , whereas DBP non-dipping rate significantly increased in the severe OSAHS patients( 54. 3% ) ( P lt;0. 05) . For the mild OSAHS patients, blood pressure was found to be correlated positively with the body mass index ( correlation coefficient for day time SBP was 0. 26, and for DBP was 0. 22) , the arousal index ( correlation coefficient for day time SBP was 0. 25, and for DBP was 0. 17) , and heart rate variation ( correlation coefficient for night time SBP was 0. 18, and for DBP was 0. 17) . For the moderate OSAHS patients, a positive correlation was also found between blood pressure and AHI ( correlation coefficient for day time SBP was 0. 31, and for DBP was 0. 22, correlation coefficient fornight time SBP was 0. 26) , and between blood pressure and the longest hypopnea time during sleep ( LH) ( correlation coefficient for night time DBP was 0. 2) . For the severe OSAHS patients, blood pressure was correlated positively with apnea index ( AI) ( correlation coefficient for day time SBP was 0. 61, and for DBP was 0. 5, correlation coefficient for night time SBP was 0. 57 and for night time DBP was 0. 48) . Conclusions OSAHS has ber impact on SBP than on DBP. DBP hypertension and SBP non-dipping are usually found in early OSAHS-affected patients. Factors affecting blood pressure differ with the severity of the OSAHS.
Obstructive sleep apnea hypopnea syndrome (OSAHS) can affect the growth and development of minors. Although the gold standard for OSAHS diagnosis is an overnight polysomnography, its clinical application is limited due to the high requirements for equipment and environmental conditions. Body shape indicators can reflect the accumulation of fat in specific parts of the body. In recent years, body shape indicators (body mass index, neck circumference, waist circumference, waist to hip ratio, waist to height ratio, neck circumference to height ratio) have been increasingly used in the evaluation of minor OSAHS. This article will review the application of the above body shape indicators in the evaluation of minor OSAHS, aiming to provide a basis for better use of these indicators in the diagnosis and treatment of minor OSAHS.
Objective To investigate the possible association between serum level of hepatocyte growth factor( HGF) and obstructive sleep apnea hypopnea syndrome( OSAHS) with hypertension.Methods 58 cases of OSAHS without hypertension, 61 cases of OSAHS with hypertension, and 50 normal controls were enrolled. Serum level of HGF was measured by enzyme-linked immunosorbent assay( ELISA) , and the relationships between the serum HGF level and blood pressure( BP) , apnea hypopnea index( AHI) , lowest SaO2 ( LSaO2 ) were analyzed by linear correlation analysis. Results The serum HGF level ( pg/mL) was 761. 46 ±60. 18, 970. 87 ±60. 94, and 487. 34 ±45. 52 in the OSAHS patients without hypertention, OSAHS patients with hypertention, and normal subjects, respectively. Which was significantly higher in the OSAHSpatients than the normal subjects, and highest in the OSAHS patients with hypertension( P lt; 0. 05) . The serum HGF level was positively related to AHI( r = 0. 452, P lt;0. 05) and negatively related to LSaO2 ( r =- 0. 328, P lt;0. 05) in the OSAHS patients without hypertention, positively related to AHI, SBP, DBP( r =0. 670, P lt;0. 01; r =0. 535, P lt;0. 05; r =0. 424, P lt;0. 05) and negatively related to LSaO2 ( r = - 0. 572,P lt;0. 01) in the OSAHS patients with hypertension. Conclusions SerumHGF level increases significantly in patients with OSAHS especialy in OSAHS patients with hypertension, and positively correlates with the severity of OSAHS and hypertension.
ObjectiveTo observe the impact of obstructive sleep apnea-hyponea syndrome (OSAHS) on the severity of pulmonary thromboembolism (PTE) and its treatment strategies. MethodsPTE patients hospitalized in our department between January 2006 and December 2012 were screened for this study, including 16 patients with OSAHS and 20 patients without OSAHS, and the difference in clinical characteristics such as arterial blood gas, apnea-hypopnea index, lowest pulse oxygen saturation (LSpO2) and treatment methods were analyzed and compared between the two groups. ResultsAs compared to PTE patients without OSAHS, the age of patients was lower[(53.4±12.1), (64.5±9.8) years; P=0.005], while body mass index[(29.3±2.2), (26.1±3.3) kg/m2, P=0.002] and smoking index (150±24, 101±18; P<0.001) were higher in PTE patients with OSAHS. Additionally, significantly lower LSpO2[(71.7±8.3), (79.4±7.1) mm Hg (1 mm Hg=0.133 kPa); P=0.005] and more lung segments (8±3, 5±2; P=0.001) were involved in PTE patients with OSAHS. In this cohort, all patients received anticoagulation and/or thrombolysis treatment, but the rate of continuous positive airway pressure (CPAP) ventilation application was significantly higher in PTE patients with OSAHS. ConclusionPTE patients with OSAHS have relatively lower age but serious condition, and both anticoagulation and CPAP should be used in the clinical treatment.
Objective To explore the relationship between uric acid (UA) level and cardiovascular disease in patients with OSAHS and its clinical significance. Methods The electronic medical record system of the First hospital of Lanzhou University was used to collect 475 subjects who completed polysomnography (PSG) during hospitalization from January 2019 to May 2020. According to the Guidelines for the Diagnosis and Treatment of Obstructive Sleep Apnea Hypopnea Syndrome (Basic Version), the patients were divided into four group: control group [apnea-hypopnea index (AHI) <5 times/h, n=96], mild group (5≤AHI≤15 times/h, n=130), moderate group (15<AHI≤30 times/h, n=112), and severe group (AHI>30 times/h, n=137). The age, gender, body mass index (BMI), smoking history, drinking history, hypertension, diabetes mellitus, cardiovascular disease and biochemical indexes [including triglyceride, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, glucose, UA, blood urea nitrogen (BUN), serum creatinine, lactate dehydrogenase, homocysteine], PSG indexes were observed and compared among the four groups, and the differences were compared by appropriate statistical methods. Binary logistic regression model was used to evaluate the correlation between various risk factors and cardiovascular disease. Results There were statistically significant differences in age, gender, BMI, drinking history, hypertension and cardiovascular disease among the 4 groups (P<0.05). The levels of UA and BUN in mild, moderate and severe groups were higher than those in the control group, with statistical significance (P<0.05). With the increasing of OSAHS severity, the level of UA increased. There was statistical significance in the incidence of cardiovascular disease among the four groups (P<0.05), and the highest incidence of arrhythmia was found among the four groups. And the incidence of cardiovascular disease increases with the increasing of OSAHS severity. Binary Logistic regression analysis showed that the risk factors for cardiovascular disease in OSAHS patients were age, UA and BUN (P<0.05). Conclusions The occurrence of cardiovascular disease in OSAHS patients is positively correlated with the severity of OSAHS. The level of UA can be used as an independent risk factor for cardiovascular disease in OSAHS patients. Therefore, reducing the level of UA may have positive significance for the prevention and control of the prevalence and mortality of cardiovascular disease in OSAHS patients.
Objective To investigate the changes in mitochondrial morphology, structure and function in rats with severe intermittent hypoxia, as well as the effects of intermittent hypoxia and its severity on cognitive function. Methods A total of 18 rats were selected to construct a model of severe intermittent hypoxia, which were divided into a normal control group, an intermittent air control group, and a 5% intermittent hypoxia group for 8 weeks, with 6 rats in each group. The structural and functional changes of mitochondria in the hippocampal CA1 region were observed. A total of 30 rats were randomly divided into 5 groups: a normal control group, an intermittent air control group, a 5% intermittent hypoxia 4-week group, a 5% intermittent hypoxia 6-week group, and a 5% intermittent hypoxia 8-week group, with 6 rats in each group. The cognitive function of the rats in each group was evaluated by Morris water maze experiment. Results In the mitochondria of the hippocampal CA1 region of severely intermittent hypoxic rats, bilayer membranes or multilayer membranes were visible, the mitochondria were swollen, cristae were broken and vacuolated, and their respiratory function was significantly weakened, the membrane permeability was increased, and the membrane potential was reduced. In the Morris water maze, there was no significant difference in swimming speed between the rats. With the prolongation of intermittent hypoxia action time, the latency of finding the hidden platform in each group of rats increased significantly, and the residence time of the target quadrant decreased significantly. Conclusions Mitochondrial structure in the hippocampal CA1 region of the rat brain is destroyed during severe intermittent hypoxia, and dysfunction and cognitive impairment occur. With the prolongation of intermittent hypoxic injury, the degree of cognitive impairment worsens.
Objective To explore effects of edaravone on apoptosis and expressions of apoptotic proteins Smac and XIAP in hippocampal CA1 pyramidal cell of rats under intermittent hypoxia. Methods A total of 96 adult male Wistar rats were randomly divided into control group, 5% intermittent hypoxic group and edaravone group, and each group was divided into 4 time groups at 7 d, 14 d, 21 d and 28 d, respectively, with 8 rats in each subgroup. The content of reactive oxygen species (ROS) in hippocampal tissues of the experimental rats was detected by the reactive oxygen species detection kit. Immunohistochemistry and Western blot were used to detect the expressions of Smac and XIAP protein in hippocampal CA1 region. The Tunel method detected the apoptosis of neurons. Results Compared with the control group, the content of ROS, the expressions of Smac and XIAP proteins and the neuronal apoptosis index in the hippocampus were increased in the 5% intermittent hypoxia group and the edaravone group at each time point (all P<0.05). The content of ROS, the Smac protein expression and the neuronal apoptosis index in the edaravone group were significantly lower than those in the 5% intermittent hypoxia group (all P<0.05). The expression of XIAP protein in the edaravone group was significantly higher than that in the 5% intermittent hypoxia group (P<0.05). Conclusion Edaravone may improve the antioxidant capacity of the body by scavenging oxygen free radicals and regulate Smac and XIAP- mediated apoptosis, thus playing a protective role on neurons.
ObjectiveTo observe the relationship of serum tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), and C-reactive protein (CRP) with obstructive sleep apnea hypopnea syndrome (OSAHS) associated pulmonary hypertension (OSAHS-PH). MethodsFrom September 2013 to October 2014, 38 OSAHS patients, 32 OSAHS-PH patients and 35 healthy subjects were enrolled from the General Hospital of Ningxia Medical University. OSAHS was diagnosed by polysomnography. The pulmonary artery systolic pressure (PASP) was measured by echocardiograph, and the diagnose criteria for pulmonary hypertension was PASP≥40 mm Hg. Serum TNF-α, IL-6, CRP and endothelin 1 (ET-1) were detected by enzyme-linked immunosorbent assay. The correlation between TNF-α, IL-6, CRP, ET-1 and PASP was analyzed. ResultsThe serum levels of TNF-α, IL-6, CRP and ET-1 were remarkably different among three groups (F=55.34, 25.05, 23.85, 34.06 respectively; all P < 0.05). The levels of TNF-α, IL-6, CRP and ET-1 in the OSAHS group were higher than those in the healthy group, and lower than those in the OSAHS-PH group (all P < 0.05). The PASP was positively correlated with the levels of the four factors (r=0.755, 0.762, 0.747, 0.759 respectively; all P < 0.01). ConclusionThe levels of serum TNF-α, IL-6 and CRP are correlated with pulmonary hypertension and they may be involved in the process of OSAHS-PH.
Objective To explore the difference between the hemorheology levels and the expression of hypoxia inducible factor 1α/2α (HIF-1α/2α) in the peripheral blood mononuclear cells of the Tibetan and Han patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods This research recruited 30 high-risk Tibetan and Han patients with OSAHS, and 30 Tibetan and Han healthy volunteers at the same period. The whole blood viscometer was used to detect the high shear rate of whole blood viscosity, low shear rate of whole blood viscosity, plasma viscosity ratio, red blood cell aggregation index, and hematocrit in each group. RT-qPCR and Western blot assays were used to detect the mRNA and protein levels of phosphoinositide 3-kinase (PI3K), serine/threonine kinase (AKT), nuclear factor-κB (NF-κB) p65, HIF-1α and HIF-2α in peripheral blood mononuclear cells. Results The hemorheology level of Tibetan OSAHS patients was significantly higher than that of healthy Tibetans and Han OSAHS patients (P<0.05), and the hemorheology level of Han OSAHS patients was significantly higher than that of Han healthy people (P<0.05) . The mRNA and protein levels of PI3K, AKT, NF-κB p65 and HIF-1α in the peripheral blood mononuclear cells of Tibetan OSAHS patients were significantly higher than those of the healthy Tibetans or Han people, and these indexes of the Han OSAHS patients were significantly higher than those of the Han healthy people (all P<0.05), while HIF-2α mRNA and protein levels were significantly lower than those of healthy Han people (all P<0.05). Conclusion The upregulation of HIF-1α level and downregulation of HIF-2α expression in peripheral blood mononuclear cells of OSAHS patients depend on the activation of the PI3K/AKT/NF-κB p65 signaling pathway, and the hemorheological level of Tibetan OSAHS patients is higher than that of Han OSAHS patients.