Attenuated endothelium-dependent vascular relaxation in patients with sleep apnoea
Attenuated endothelium-dependent vascular relaxation in patients with sleep apnoea
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DOI：
10.1097/00004872-199605000-00006
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发表时间：
1996-05-01
影响因子：
4.9
通讯作者：
Hedner, JA
中科院分区：
文献类型：
--
作者：
Carlson, JT;Rangemark, C;Hedner, JA
目的评价阻塞性睡眠呼吸暂停患者的血管内皮依赖性功能。设计与方法对8例正常血压者和8例阻塞性睡眠呼吸暂停患者，以及8例正常血压者和8例高血压患者，分别采用分次臂动脉注射乙酰胆碱(10~60 mg/min)和硝普钠(1~6 mg/min)后的前臂血流和血管阻力进行研究。结果患者输注乙酰胆碱后前臂血流量明显低于对照组(峰值血流量分别为6.0+/-0.7和9.8+/-1.5ml/min/100g)，但高血压组与正常血压组比较差异无统计学意义。然而，与相应的高血压对照组相比，高血压阻塞性睡眠呼吸暂停组对硝普钠的血流反应减少。阻塞性睡眠呼吸暂停患者应用乙酰胆碱和硝普钠后前臂最小血管阻力明显高于对照组。结论阻塞性睡眠呼吸暂停患者血管内皮依赖性舒张性降低，且与高血压无关。在合并高血压的阻塞性睡眠呼吸暂停患者中，还发现了内皮非依赖性血管松弛的额外缺陷。这些发现表明阻塞性睡眠呼吸暂停和系统性高血压之间存在血管病理联系。
Objective To evaluate endothelium-dependent vascular function in obstructive sleep apnoea patients.Design and methods Forearm blood flow and vascular resistance were studied in eight normotensives and eight obstructive sleep apnoea patients and also in eight normotensive and eight hypertensive controls after graded brachial artery infusion of acetylcholine (10-60 mu g/min) and sodium nitroprusside (1-6 mu g/min), respectively. Patients and controls were matched for age, sex and body weightResults Forearm blood flow after acetylcholine infusion was reduced in patients compared with that in controls (peak flows were 6.0 +/- 0.7 and 9.8 +/- 1.5 ml/min for 100 g, respectively), but there was no difference between hypertensive and normotensive subjects. However, the hypertensive obstructive sleep apnoea group exhibited a reduced flow response to sodium nitroprusside compared with that of their corresponding hypertensive controls. Minimal forearm vascular resistance after acetylcholine infusion and after sodium nitroprusside infusion was higher in obstructive sleep apnoea patients than it was in controls.Conclusions Endothelium-dependent vascular relaxation in patients with obstructive sleep apnoea was reduced independently of hypertension. An additional defect in endothelium-independent vascular relaxation was found in obstructive sleep apnoea patients with hypertension. These findings suggest a vascular pathogenetic link between obstructive sleep apnoea and systemic hypertension.