The Changes Of Plasma Endothelin-1, Neuropeptide Y Levels Before And After Nasal-continuous Positive Airway Pressure Treatment On OSAHS With Hypertension Patients

Objectives:1. To observe the changes of plasma endothelin-1, neuropeptide Y in obstructive sleep apnea-hypopnea syndrome (OSAHS) and OSAHS with hypertension in order to investigate the role of endothelin-1(ET-1), neuropeptide Y (NPY) in the mechanism of patients with OSAHS complicated with hypertension.2. To analyze the effects of treatment with nasal-continuous positive airway pressure (CPAP) on hypertension, ET-1 and NPY of OSAHS with hypertension.Methods:1. All of the subjects underwent overnight polysomnography.Their blood pressure was measured.Subjects were divided into four sub-groups according to diagnostic criteria of OSAHS and hypertension: 30 cases of OSAHS with normotensive, 30 cases of OSAHS with hypertensive, 30 cases of hypertension without OSAHS and 30 cases of control people. The ET-1 and NPY levels were measured with ELISA in all of the people.2. After 1 week of nasal-continuous positive airway pressure (CPAP) therapy in 25 OSAHS with hypertension patients, the PSG was reviewed, blood pressure and the levels of ET-1 and NPY were measured again changed observation.Results:1. The levels of ET-1 and NPY in simple OSAHS group, simple hypertension group and in OSAHS with hypertension group were higher than that in the control group (P<0.01), and OSAHS with hypertension group was the highest.There were significant differences between OSAHS and OSAHS with hypertension.2. The ET-1 and NPY concentrations are decreased in OSAHS with hypertension after CPAP therapy (P<0.05). The blood pressure is tending to decline, but there is no different (P>0.05).3. Plasma ET-1 and NPY levels positively related with AHI, ODI, MSBP and MDBP (P<0.05), and negatively with LSaO2 and MSaO2 (P<0.01).4. By stepwise multiple linear regression analysis showed that AHI was the risk factor for ET-1 and NPY, MSBP and MDBP were affected by ET-1 and NPY(P<0.01).Conclusions:1. Intermittent hypoxia is the risk factor for ET-1 and NPY.2. ET-1 and NPY may play a role in the process of OSAHS with hypertension.3. The levels of ET-1, NPY are decreased in OSAHS with hypertension after the treatment of CPAP. It indicates that CPAP therapy could improve endothelial function and reduce the excitability of sympathetic.