Serum Levels Of TGF- ?1, PPAR- ? And ET-1 In Patients With Obstructive Sleep Apnea Combined With Pulmonary Hypertension And Their Clinical Significance

Objective: The purpose of this experiment was to detect the expression levels of transforming growth factor(TGF-?1),peroxidase proliferator activated receptors(PPAR-?)and vascular endovascular 1(ET-1)in patients with Obstructive sleep apnea(OSA)complicated with Pulmonary hypertension(PH),and to analyze its relationship with Pulmonary arterial systolic pressure.Meanwhile,the role of TGF-?1,PPAR-? and ET-1 in OSA combined with PH was also discussed.Methods: A total of 56 patients(37 males and 19 females,aged between 27 and69 years old)with OSA were confirmed by PSG in the department of respiratory and critical care medicine of Gansu provincial people's hospital from December 2018 to December 2019.OSA patients were divided into OSA combined with PH group(group A,n=24)and OSA uncombined with PH group(group B,n=32)according to the PASP results of echocardiography,PASP>35mmHg was used as the PH standard.The control group consisted of 28 healthy patients in the physical examination center of our hospital,including 17 males and 11 females,aged between 28 and 59 years old.The general clinical data of the subjects were collected,and the expression levels of TGF-?1?PPAR-? and ET-1 in serum were measured by ELISA.SPSS 23.0 software was used for statistical analysis of the experimental data.Results: 1.The serum levels of TGF-?1?PPAR-? and ET-1 in the three groups were statistically significant(P < 0.05).The levels of TGF-?1and ET-1 in OSA combined with PH group were higher than those in OSA group and healthy control group(P < 0.05),and the levels of TGF-?1and ET-1 in OSA group were higher than those in healthy control group(P < 0.05).The PPAR-? level of OSA combined with PH group was lower than that of OSA group and healthy control group(P < 0.05),while the PPAR-? initiation level of OSA group was lower than that of healthy control group(P < 0.05).2.TGF-?1 was positively correlated with PASP(r=0.90,P < 0.01),serum PPAR-? was negatively correlated with PASP(r=-0.61,P < 0.01),and serum ET-1was positively correlated with PASP(r=0.89,P < 0.01).3.Serum TGF-?1 was negatively correlated with PPAR-?(r=-0.69,P < 0.01),serum PPAR-? was negatively correlated with ET-1(r=-0.39,P < 0.01),and serum TGF-?1 was positively correlated with ET-1(r=0.73,P < 0.01).Conclusion: 1.The serum levels of TGF-?1 and ET-1 were significantly increased in patients with OSA combined with PH,while the levels of PPAR-? weresignificantly decreased,suggesting that these cytokines may be involved in the occurrence and development of OSA combined with PH.2.TGF-?1 and ET-1 levels of OSA patients were positively correlated with PASP level,while PPAR-? level was negatively correlated with PASP level,suggesting that the three may be one of the indicators to evaluate PASP changes in OSA patients.3.The serum TGF-?1 level of OSA patients was positively correlated with the level of ET-1 and negatively correlated with the level of PPAR-?,suggesting that the three may interact with each other in the development of OSA combined with PH.