Snoring as a Determinant Factor of Oxidative Stress in the Airway of Patients with Obstructive Sleep Apnea
Snoring as a Determinant Factor of Oxidative Stress in the Airway of Patients with Obstructive Sleep Apnea
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DOI：
10.1007/s00408-016-9869-0
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发表时间：
2016-06-01
期刊：
影响因子：
5
通讯作者：
Casan Clara, Pere
中科院分区：
文献类型：
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作者：
Fernandez Alvarez, Ramon;Rubinos Cuadrado, Gemma;Casan Clara, Pere
在阻塞性睡眠呼吸暂停低通气综合征(OSAS)中，呼吸道塌陷和振动会导致局部和全身炎症反应和氧化应激(OS)。我们的目的是确定OSAS患者和非OSAS对照组的呼吸道OS的存在，并确定其与CPAP治疗和其他临床变量的关系。我们进行了一项重复测量的前瞻性观察性病例对照研究。我们招募了连续的通过多导睡眠图确诊的SAHS患者和一组平行的对照组。我们收集了鼻腔持续正压(CPAP)治疗前和4个月后呼气冷凝液(EBC)的样本。OS的标志物为8-异前列腺素(8-IPN)。分析的变量包括年龄、性别、人体测量变量、呼吸暂停低通气指数(AHI)、鼾声、氧合和多导睡眠图变量。研究包括20名患者和10名对照组。8-IPN初值为6.8(1.9)，鼻腔CPAP后为5.3(1.2)pg/ml(P=0.02)。对照组8-IPN为5.6(1.1)pg/ml(P=0.04)。8-IPN与鼾声、AHI、BMI、夜间减饱和指数、非快速眼动睡眠显著相关。在多变量分析中，只有鼾声是8-IPN的显著预测因子，鼾声可能是OSAS患者呼吸道局部OS存在的潜在现象，而不是OSAS严重程度。
In obstructive sleep apnea-hypopnea syndrome (OSAS), airway collapses and vibrations cause local and systemic inflammatory response and oxidative stress (OS). Our objective was to determine the presence of OS in the airway of patients with OSAS compared with controls without OSAS and determine its relation to treatment with CPAP and other clinical variables.We performed a prospective observational case-control study with repeated measures. We recruited consecutive patients with SAHS diagnosed using complete polysomnography, and a parallel control group. We collected a sample of exhaled breath condensate (EBC) prior to nasal continuous positive airway pressure (CPAP) treatment and again after 4 months. The marker of OS used was 8-isoprostane (8-IPN). The variables analyzed were age, sex, anthropometric variables, apnea-hypopnea index (AHI), snoring, oxygenation, and polysomnographic variables.The study included 20 patients and 10 controls. In cases, the initial value of 8-IPN was 6.8 (1.9), and after nasal CPAP, it was 5.3 (1.2) pg/ml (p = 0.02). In controls, the value of 8-IPN was 5.6 (1.1) pg/ml (p = 0.04 compared to initial values). 8-IPN showed significant correlation with snoring, AHI, BMI, nocturnal desaturation index, and non-REM sleep. On multivariate analysis, only snoring was a significant predictor of 8-IPN.Snoring, and not OSAS severity, could be the phenomenon underlying the presence of local OS measured in the airway of patients with OSAS.