Expression and significance of plasma vascular endothelial growth factor-A and insulin-like growth factor-2 in patients with hypertension complicated with obstructive sleep apnea
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摘要: 目的:观察高血压合并不同程度阻塞性睡眠呼吸暂停(OSA)患者血浆血管内皮生长因子-A(VEGF-A)、胰岛素样生长因子-2(IGF-2)的水平,探讨其与心脏结构和血压变化之间的关系。方法:入选患者共76例,分为单纯高血压组(A组,25例)、高血压合并轻中度OSA组(B组,25例)、高血压合并重度OSA组(C组,26例)。收集3组患者一般资料、心脏彩超及动态血压结果,用酶联免疫吸附法测定血浆VEGF-A及IGF-2浓度。结果:与A组比较,B组及C组VEGF-A水平显著升高[(133.04±14.82) pg/ml,(183.47±15.10) pg/ml,(224.75±28.72) pg/ml,P<0.05],IGF-2水平也显著升高[(319.93±32.85) ng/ml,(380.49±28.98) ng/ml,(396.28±29.01) ng/ml,P<0.05]。相较于A组,B组夜间平均舒张压及24 h平均舒张压明显升高,C组24 h和夜间平均收缩压及舒张压、白昼平均舒张压明显升高,差异均具有统计学意义(均P<0.05)。C组左房前后径及左心室后壁厚度较A组明显增加(均P<0.05)。B组及C组血浆VEGF-A、IGF-2水平均与呼吸暂停低通气指数呈正相关,VEGF-A与睡眠中平均血氧饱和度呈负相关。在3组患者中,VEGF-A与IGF-2呈显著正相关,VEGF-A、IGF-2水平与平均血压均呈正相关,且VEGF-A与左心结构相关指标呈正相关。结论:OSA能够使高血压患者血压进一步升高,并影响左心结构。合并OSA的高血压患者血浆VEGF-A及IGF-2水平进一步升高,可能参与了OSA合并高血压的发生发展过程。
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关键词:
- 高血压 /
- 阻塞性睡眠呼吸暂停 /
- 血管内皮因子-A /
- 胰岛素样生长因子-2
Abstract: Objective: To investigate the plasma levels of vascular endothelial growth factor-A(VEGF-A) and insulin-like growth factor-2(IGF-2) in hypertension patients with different degrees of obstructive sleep apnea(OSA), and to explore their relationship with cardiac structure and blood pressure. Method: A total of 76 patients were enrolled and divided into three groups: patients with hypertension alone(A group, n=25), patients with hypertension and mild or moderate OSA(B group, n=25), patients with hypertension and severe OSA(C group, n=26). The clinical data, results of cardiac color Doppler ultrasound and dynamic blood pressure were collected. Plasma VEGF-A and IGF-2 levels were measured by ELISA. Result: Compared with the group A, VEGF-A levels in the group B and C increased significantly[(133.04±14.82) pg/ml,(183.47±15.10) pg/ml,(224.75±28.70 pg/ml, P<0.05], the IGF-2 level also increased[(319.93±32.85) ng/ml,(380.49±28.98) ng/ml,(396.28±29.01) ng/ml, P<0.05]. Compared with group A, the nocturnal mean diastolic blood pressure and 24-hour mean diastolic blood pressure increased significantly in group B, and the 24-hour and nocturnal mean systolic blood pressure and diastolic blood pressure, daytime mean diastolic blood pressure in group C were increased significantly(all P<0.05). The left atrium diameter and the left ventricle posterior wall thickness in group C were significantly higher than those in group A(both P<0.05). Levels of VEGF-A and IGF-2 in group B and C were positively correlated with apnea hypopnea index, and the VEGF-A level was negatively correlated with the average pulse oxygen saturation during sleep. In three groups, the VEGF-A level was positively correlated with IGF-2, VEGF-A and IGF-2 levels were positively correlated with blood pressures, and the VEGF-A level was positively correlated with left cardiac structure.Conclusion: In hypertension patients with OSA, the blood pressure increases and the left heart structure changes, plasma VEGF-A and IGF-2 increase further, suggesting that they may be involved in developing OSA complicated with hypertension. -
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