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目的评价经鼻持续气道内正压通气(nCPAP)对阻塞性睡眠呼吸暂停低通气综合征(OS-AHS)患者食欲素A(orexin-A)及代谢紊乱的影响。方法测定23例OSAHS患者在nCPAP治疗前及治疗12个月血浆食欲素A水平及部分代谢参数的变化。结果治疗12个月患者血浆食欲素A水平、ESS评分、微觉醒指数(MAI)、血胆固醇(Chol)、甘油三酯(TG)均较治疗前明显降低,高密度脂蛋白(HDL)升高,差异有统计学意义(P均为<0.05);治疗前后体质量指数(BMI)无明显改变(P>0.05);OSAHS患者血浆食欲素A水平与AHI及MAI呈正相关(r=0.542,0.671,P<0.05),与夜间最低血氧饱和度(LSO2)呈负相关(r=-0.611,P<0.05),与BMI无相关性(r=0.311,P>0.05)。结论OSAHS患者血浆食欲素A水平升高,并与病情严重程度相关;长期nCPAP治疗能改善血浆食欲素A水平及脂质代谢紊乱。
Objective To evaluate the effect of nasal continuous positive airway pressure (nCPAP) on orexin-A and metabolic disorders in patients with obstructive sleep apnea-hypopnea syndrome (OS-AHS). Methods Twenty-three OSAHS patients underwent nCPAP before and 12 months after treatment for plasma orexin-A levels and some metabolic parameters. Results The levels of plasma orexin A, ESS score, MAI, Chol and triglyceride were significantly lower and the content of high density lipoprotein (HDL) was higher in 12 months after treatment than those before treatment (P <0.05). There was no significant change in body mass index (BMI) before and after treatment (P> 0.05). The level of plasma orexin A in OSAHS patients was positively correlated with AHI and MAI (r = 0.542, (R = -0.611, P <0.05), but no correlation with BMI (r = 0.311, P> 0.05). Conclusion OSAHS patients with elevated levels of plasma orexin A, and with the severity of the disease; long-term nCPAP treatment can improve plasma orexin-A levels and lipid metabolism disorders.