The Study Of Changes On The Levels Of Plasma PTX3and HIF-1a In Patients With OSAHS And CIH-rat Model

Objective:To observe the changes of the plasma pentraxin3(PTX3) and hyp-oxia-inducible factor-1α(HIF-1α) levels during the development of chro-nic intermittent hypoxia(CIH)and to intervene with NAC, and probe the relativity of them in CIH-rat model. To investigate the effect of freque-ncy of intermittent hypoxia of obstructive sleep apnea-hypopnea syndrome(OSAHS) on the levels of the plasma pentraxin3(PTX3) and hypoxia-inducible factor-1α(HIF-1α). To provide the mechanism and the effect of CIH on levels of plasma pentraxin3(PTX3) and hypoxia-inducible factor-1α(HIF-1α) in OSAHSMethods:The experiment was divided to two parts.Part one:All cases are collected by monitoring of polysomno-graphy(PSG).There are three groups:(1) group A:healthy control,25cases;(2)group B:patients with moderate to severe OSAHS,50cases;(3)group C:moderate to severe OSAHS patients treated with continuous positive airway pressure (CPAP) for1month,10cases.Apnea Hypopnea Index(AHI) and Lowest Oxygen Saturation (LS02) and the percentage of the time that oxygen saturation below90%(T-SaO2<90%) were observed. In the morning of finishing PSG, blood specimens were collected in all groups, then ELISA was used to examine the levels of PTX3and HIF-lα in serum.Part two:Twenty-four male Sprague-Dawley(SD)rats were divided into four groups:CIH group(CIHl),CIH+NAC group(CIH2), CIH+NS group(CIH3), and control group (NC). CIH rats were subjected to alternating cycles of hypoxia(6-8%O2in N2for20s～25s)and normoxia(21%O2in N2for2min)every180S for7h/d.All CIH rats were treated for six weeks. NC rats were not treated and were observed for six weeks. CIH2group rats were injected N-acetylcysteine (NAC;800mg.kg-1. day-1,i. p.)for six weeks, and CIH3rats were injected NS (4ml. kg-1. d-1, i. p)for six weeks. Then Enzyme Linked Immunosorbent Assay (ELISA) was used to detect the levels of the plasma pentraxin3(PTX3) and hypoxia-inducible factor-l α (HIF-lα).Results:part one: Plasma PTX3levels and HIF-la in the moderate-to-severe OSAHS group were significantly higher than those in control group(P<0.05). There was a positive correlation between PTX3levels and HIF-la levels in the moderate to severe OSAHS group (r=0.281. P<0.05). Both Plasma PTX3and HIF-la levels positively related to AHI and T-SaO2<90%, while negatively related to the lowest oxygen saturation. Plasma PTX3and HIF-la levels were significantly reduced (P<0.05) in the moderate-to-severe OSAHS patients after1month of CPAP therapy.Part two:Plasma pentraxin3and hypoxia-inducible factor-la levels was significantly elevated in CIH1and CIH3rats on week6compared with that in NC group (P<0.05). Plasma pentraxin3and hypoxia-inducible factor-la levels was obviously decreased in CIH2rats on week6compared with that in CIH1and CIH3rats (P<0.05).Conclusion:1. Plasma PTX3and HIF-la levels were significantly elevated in patients with moderate to severe OSAHS, and showed positive correlation with AHI and the degree of hypoxia. Plasma PTX3and HIF-la levels were significantly reduced in moderate to severe OSAHS patients after1month of CPAP therapy. This suggests that the changes of plasma PTX3and HIF-la levels possibly are associated with CIH, and plasma PTX3and HIF-la levels in OSAHS can be managed by CPAP.2. Plasma PTX3and HIF-la levels in CIH rats were significantly increased. It verifies that CIH plays an important role in increasing levels of PTX3and HIF-la.3. NAC can reduce the levels of PTX3and HIF-la in rats of CIH-induced. It illustrates oxidative stress may be one of the important mechanisms for the increase of levels of plasma PTX3and HIF-la of CIH-induced.