| Objective:To investigate the malondialdehyde(MDA), total antioxidant capacity(T- AOC)and norepinephrine(NE) in patients with obstructive sleep apnea—hypopnea syndrome(OSAHS),OSAHS combined hypertension and snoring of changes in peripheral blood. To explore the oxidative stress and the role of sympathetic nerve activity on the pathogenesis of OSAHS combined hypertension.Methods:A total of 88 patients were recruited from the Sleep Monitoring Room of Second Affiliated Hospital of Nanchang University from June 2013 to August 2014. Based on Polysomnography(PSG), blood pressure measurement and disease history,88 subjects were divided into three groups: OSAHS group(O)32 cases,OSAHS combined hypertension group(OH) 29 cases, the snoring control group(N) 27 cases.To measure blood pressure before and after sleep and collect the blood samples of subjects..ELISA was used to detect the plasma expression level of NE,Thibabituric Acid(TBA) was used to detect the plasma MDA level, colorimetric method was used to detect the plasma T-AOC level, We put the experimental group and control group of matching age, BMI, age, obesity and other confounding factors on the result of oxidative stress were excluded. and analyze the possible relationships between NE,T-AOC, MDAand clinical characteristics of subjects.Results:1. Plasma norepinephrine(NE) concentration : snoring control group(N) was1.8±0.5mg/L, OSAHS(O)was 2.7±0.9 mg/L, OSAHS combined hypertension group(OH)was 3.9±1.4 mg/L. The plasma NE was higher in O group and OH group than N group(P<0.01),and OH is signifiantly higher than O group.There were statistical significances among all groups(P<0.01).2.Plasma malondialdehyde(MDA) concentration : N group was 3.85 ± 0.36nmol/m L, O group was 5.45±0.62 nmol/m L, OH group was 6.69±1.31 nmol/m L. The plasma MDA was higher in O group and OH group than N group,and OH is signifiantly higher than O group.There were statistical significances among all groups(P<0.01).3.Plasma total antioxidant capacity(T-AOC) concentration : N group was11.18±1.12 U/ml, O group was 9.82±0.57 U/ml, OH group was 8.36±0.45 U/ml. The plasma T-AOC was higher in N group than O group and OH group,and OH is signifiantly lower than O group.There were statistical significances among all groups(P<0.01).4. PSG monitoring indicators: The AHI was lower in N group than O group and OH group, There were statistical significances among all groups(P<0.01). and OH is signifiantly higher than O group. there was no statistical significances between O group and OH group(P>0.05). the LSa02 was higher in N group than O group and OH group, There were statistical significances among all groups(P < 0.01). and OH is signifiantly lower than O group. there was no statistical significances between O group and OH group(P>0.05).5. Mean arterial pressure before and after sleep:Mean arterial pressure before and after sleep in OH group and O group were significantly higher than in N group.Look from the process to the change of mean arterial pressure before and after sleep,mean arterial pressure after sleep in O group was higher than before sleeping(97.9±6.6mm Hg VS 92.7±8.2 mm Hg),, rise difference was 7.4±5.2mm Hg, there was statistically significant(t=3.942, p=0.000). mean arterial pressure after sleep in OH group was higher than before sleeping(108.6±8.1 mm Hg VS 99.1±4.7 mm Hg), rise difference was9.5 ± 7.1mm Hg, there was statistically significant(t=5.968, p=0.000). and OH is signifiantly higher than O group.There were statistical significances among all groups(p<0.01). mean arterial pressure after sleep in N group actually fell before sleeping(89.1±5.0 mm Hg VS 89.7±6.2 mm Hg), there was no statistically significant difference(t = 0.246, p = 0.246).6. Correlation analysis: The plasma NE levels were correlated positively with mean arterial pressure after sleep,AHI and MDA(γ>0.5,p<0.01),were correlated negatively with LSa02(γ=-0.762, p < 0.01),were correlated negatively with T-AOC(γ=-0.437,P<0.01), The plasma MDA levels were correlated positively with AHI and mean arterial pressure after sleep(γ>0.5,p<0.01), were correlated negatively with LSa O2(γ=-0.682,p<0.01). The plasma T- AOC levels were correlated negatively with AHI(γ=- 0.511, p<0.01), were correlated positively with LSa02(γ=0.621,p<0.01) and were correlated negatively with mean arterial pressure after sleep(γ=-0.738, p<0.01)Conclusion:1.The plasma NE in O group and OH group were higher than N group, and OH group increased more obviously, suggest OSAHS patients with or without hypertension, there are different levels of the sympathetic nervous activity, and OH group is more serious. NE were significantly positively correlated with AHI, and significantly negatively with LSa02, prompt that increased sympathetic nervous activity is correlated with disease severity and the degree of hypoxia.2. The plasma MDA in O group and OH group were higher than N group, and OH group increased more obviously, The plasma T-AOC in O group and OH group were lower than N group, and OH group declined more obviously, suggest OSAHS patients with or without hypertension, there are different levels of oxidative stress and OH group is more serious. MDA were significantly positively correlated with AHI,and significantly negatively with LSa02, T-AOC were significantly negatively correlated with AHI, and significantly positively with LSa02,prompt that oxidative stress is correlated with disease severity and the degree of hypoxia.3. Mean arterial pressure before and after sleep in OH group and O group were significantly higher than in N group. and OH group increased more obviously, mean arterial pressure after sleep in N group actually fell before sleeping, mean arterial pressure after sleep were significantly positively correlated with MDA, NE.and significantly negatively with T-AOC, suggest oxidative stress, the sympathetic nervous activity may be associated with the occurrence and development of hypertension. It’s a certain guiding role to predict the occurrence of hypertension and helpfully to early diagnosis.4. The expression level of NE was positively correlation with MDA, and negatively correlation with T- AOC, prompt oxidative stress is closely related to the sympathetic nervous activity. |
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