Exhaled breath markers in patients with obstructive sleep apnoea

Exhaled breath markers in patients with obstructive sleep apnoea
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DOI:
10.1007/s11325-007-0160-8
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发表时间:
2008-08-01
影响因子:
2.5
通讯作者:
Gratziou, Christina
Gratziou, Christina
中科院分区:
医学4区
文献类型:
--
作者:
Petrosyan, Marina;Perraki, Eleni;Gratziou, Christina

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本研究的目的是评估阻塞性睡眠呼吸暂停综合征(OSAS)患者与非呼吸暂停(肥胖和非肥胖)患者的呼吸道炎症和氧化应激指标水平,并探讨持续气道正压通气(CPAP)治疗是否可以改变这些指标。设计为回顾性观察性研究,地点设在Evgeneidio医院。26例阻塞性睡眠呼吸暂停患者和9例肥胖和10例非肥胖非呼吸暂停受试者参与了本研究。我们在CPAP治疗1个月前后测量了鼻一氧化氮(nNO)、呼出一氧化氮(eNO)、呼出一氧化碳(eCO)以及8-异前列腺素、白三烯B-4 (LTB4)、硝酸盐、过氧化氢(H2O2)和呼出冷凝水(EBC)的pH值。OSAS患者血清eNO、eCO水平明显高于对照组(p < 0.05)。OSAS患者鼻腔NO高于肥胖对照组(p < 0.01)。OSAS患者H2O2、8-异前列腺素、LTB4、硝酸盐水平均高于肥胖组(p < 0.01)。相反,OSAS患者的pH值低于非呼吸暂停对照组(p < 0.01)。CPAP治疗1个月后pH升高(p < 0.05), eNO (p < 0.001)和nNO (p < 0.05)降低。呼吸暂停/低通气指数与8-异前列腺素(r=0.42, p < 0.05)、LTB4 (r=0.35, p < 0.05)、硝酸盐(r=0.54, p < 0.001)、H2O2 (r=0.42, p < 0.05)呈正相关。与非呼吸暂停受试者相比,OSAS患者的气道存在炎症和氧化应激。呼气指标与OSAS严重程度呈正相关。一个月的CPAP治疗可改善气道炎症和氧化应激。
The objectives of the present study were to assess the level of exhaled breath markers indicating airway inflammation and oxidative stress in patients with obstructive sleep apnoea syndrome (OSAS) in comparison with non-apnoeic (obese and non-obese) subjects and investigate whether therapy with continuous positive airway pressure (CPAP) can modify them. The design was a retrospective observational study, set in Evgeneidio Hospital. Twenty-six OSAS patients and nine obese and 10 non-obese non-apnoeic subjects participated in this study. We measured nasal nitric oxide (nNO), exhaled nitric oxide (eNO), exhaled carbon monoxide (eCO) in exhaled breath, and 8-isoprostane, leukotriene B-4 (LTB4), nitrates, hydrogen peroxide (H2O2), and pH in exhaled breath condensate (EBC) before and after 1 month of CPAP therapy. The levels of eNO and eCO were higher in OSAS patients than in control subjects (p < 0.05). Nasal NO was higher in OSAS patients than in obese controls (p < 0.01). The level of H2O2, 8-isoprostane, LTB4, and nitrates were elevated in OSAS patients in comparison with obese subjects (p < 0.01). Conversely, pH was lower in OSAS patients than in non-apnoeic controls (p < 0.01). One month of CPAP therapy increased pH (p < 0.05) and reduced eNO (p < 0.001) and nNO (p < 0.05). Apnea/hypopnoea index was positively correlated with 8-isoprostane (r=0.42; p < 0.05), LTB4 (r=0.35; p < 0.05), nitrates (r=0.54; p < 0.001), and H2O2 (r=0.42; p < 0.05). Airway inflammation and oxidative stress are present in the airway of OSAS patients in contrast to non-apnoeic subjects. Exhaled breath markers are positively correlated with the severity of OSAS. One-month administration of CPAP improved airway inflammation and oxidative stress.