阻塞性睡眠呼吸暂停综合征伴高血压患者性激素与炎症因子水平的变化

Alteration of inflammatory factors and sex hormones in obstructive sleep apnea syndrome patients with hypertension

摘要:

目的 通过观察男性阻塞性睡眠呼吸暂停综合征（OSAS）伴高血压患者体内性激素和炎症指标的水平，探讨OSAS合并高血压患者性激素水平和体内慢性炎症之间的关系。方法 2010年1月至2012年12月在解放军总医院南楼呼吸科确诊的男性重度OSAS患者70例，按照是否合并高血压分为单纯OSAS组（30例）和OSAS合并高血压（OSAS-H）组（40例），并以30例年龄相近无OSAS和高血压的健康男性做为对照组，统一晨起后抽取静脉血检测血清中雌二醇（E2）、卵泡刺激素（FSH）、促黄体生成激素（LH）、孕酮（PROG）、睾酮（TEST）、C-反应蛋白（CRP）、白细胞介素（IL）-6和肿瘤坏死因子α（TNF-α）的水平。结果 OSAS-H组血清CRP、IL-6和TNF-α水平高于OSAS组和对照组（P＜0.05），OSAS组CRP水平高于对照组（P＜0.05）；OSAS-H组血清E2和PROG水平高于OSAS组和对照组（P＜0.05），OSAS组和对照组之间差异无统计学意义（P＞0.05）。结论 OSAS夜间间歇性缺氧不仅引起体内炎症因子水平增高，也使体内雌激素分泌异常，加重慢性炎症的形成和持续，在OSAS的高血压形成中可能具有重要作用。

Abstract:

Objective To observe the serum levels of inflammatory factors and sex hormones in male obstructive sleep apnea syndrome (OSAS) patients with hypertension(OSAS-H), in order to investigate the correlation between inflammation severity and sex hormone levels in the patients. Methods A total of 70 patients with polysomnography-diagnosed severe OSAS admitted in our department from January 2010 to December 2012 were recruited in this study. They were divided to 2 groups, OSAS-H group (40 cases) and OSAS group (30 cases). Another 30 age-matched health males without OSAS or hypertension served as controls. Serum contents of estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone (PROG), testosterone (TEST), C-reactive protein (CRP), interleukin (IL)-6 and tumor necrosis factor α (TNF-α) were measured. Results The serum levels of CRP, IL-6 and TNF-α were significantly higher in OSAS-H group than that in OSAS and control groups (P＜0.05), and that of CRP was obviously higher in OSAS group than in control group (P＜0.05). Levels of E2 and PROG were also significantly higher in OSAS-H group than in the other 2 groups (P＜0.05), but no difference was found in these levels between OSAS group and the controls (P＞0.05). Conclusion For these OSAS patients, intermittent hypoxia during sleep may induce not only inflammatory factors, but also abnormal estrogen secretion, and thus exacerbate the chronic inflammation. It may play an important role in the development of hypertension in OSAS patients.