Hypoxic stress and atherosclerosis in patients with sleep apnea-hypopnea syndrome

阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的特征是睡眠中反复发作的氧气减饱和。本研究旨在探讨低氧应激对OSAHS患者外周血单核细胞产生肿瘤坏死因子-α和单核细胞趋化蛋白-1的影响，以及低氧应激对血浆脂联素的影响。我们还观察了鼻腔持续正压对单核细胞产生肿瘤坏死因子-α和单核细胞趋化蛋白-1及ADPN的长期或短期影响。结果总结：(1)单核细胞产生肿瘤坏死因子-α和单核细胞趋化因子-1与阻塞性睡眠呼吸暂停低氧应激有关。这一现象可能与OSAHS动脉粥样硬化的发生发展有关。提示NCPAP治疗3个月可能有利于OSAHS患者动脉粥样硬化的预防。(2)血浆ADPn降低和肿瘤坏死因子-α升高均与阻塞性睡眠呼吸暂停低氧应激有关。短期nCPAP治疗1d后，OSAHS患者血浆ADPN抑制水平仍未完全恢复。

Obstructive sleep apnea-hypopnea syndrome(OSAHS) is characterized by recurrent episodes of oxygen desaturation during sleep. In addition, recent studies have shown that OSAHS may be one of the important independent risk factors of cardiovascular diseases.The aim of the present study was (1)to clarify the effect of hypoxic stress on the production of TNF-α and MCP-1 by peripheral blood monocytes, and (2)to investigate the impact of hypoxic stress on plasma adiponectin(ADPN) in patients with OSAHS. We also examined the long-term or the short-term effects of nasal continuous positive airway pressure(nCPAP) on the production of TNF-α and MCP-1, and ADPN.Summary of results ; (1)The elevated production of TNF-α and MCP-1 by monocytes was associated with OSAHS-induced hypoxic stress. This phenomenon may contribute to the development of atherosclerosis in OSAHS. Furthermore, it was suggested that nCPAP therapy for 3 months may be beneficial to the prevention of atherosclerosis in OSAHS. (2)Both reduced ADPN and elevated TNF-α in plasma are associated with OSAS-induced hypoxic stress. The suppressed level of plasma ADPN in OSAHS was not fully recovered by the short-term nCPAP therapy for 1 day.