Objective To explore effects of edaravone on apoptosis and expressions of apoptotic proteins Smac and XIAP in hippocampal CA1 pyramidal cell of rats under intermittent hypoxia. Methods A total of 96 adult male Wistar rats were randomly divided into control group, 5% intermittent hypoxic group and edaravone group, and each group was divided into 4 time groups at 7 d, 14 d, 21 d and 28 d, respectively, with 8 rats in each subgroup. The content of reactive oxygen species (ROS) in hippocampal tissues of the experimental rats was detected by the reactive oxygen species detection kit. Immunohistochemistry and Western blot were used to detect the expressions of Smac and XIAP protein in hippocampal CA1 region. The Tunel method detected the apoptosis of neurons. Results Compared with the control group, the content of ROS, the expressions of Smac and XIAP proteins and the neuronal apoptosis index in the hippocampus were increased in the 5% intermittent hypoxia group and the edaravone group at each time point (all P<0.05). The content of ROS, the Smac protein expression and the neuronal apoptosis index in the edaravone group were significantly lower than those in the 5% intermittent hypoxia group (all P<0.05). The expression of XIAP protein in the edaravone group was significantly higher than that in the 5% intermittent hypoxia group (P<0.05). Conclusion Edaravone may improve the antioxidant capacity of the body by scavenging oxygen free radicals and regulate Smac and XIAP- mediated apoptosis, thus playing a protective role on neurons.
Objective To investigate the changes of steps walks daily in patients with obstructive sleep apnea-hypopnea syndrome ( OSAHS) before and after the initiation of nasal continuous positive airway pressure ( nCPAP) ventilation. Methods 62 patients diagnosed by polysomnogaphy ( PSG) in the sleep respiratory disease center of Nanjing FirstHospital Affiliated to Nanjing Medical University were recruited as the OSAHS group, and divided into mild,moderate, and severe subgroups according to apnea-hypopnea index ( AHI) .28 subjects without OSAHS were recruited as the control group. All the subjects were evaluated by Epworth Sleepiness Scale ( ESS) and Functional Outcomes of Sleep Questionnaire ( FOSQ) . Steps walked daily were measured by electronic pedometer.10 patients with moderate and severe OSAHS were treated with nCPAP. Results Compared with the control group and the mild OSAHS patients, ESS scores were significantly higher while FOSQ scores and steps walked daily were significantly lower in the moderate and severe OSAHS patients ( P lt; 0. 05) . In the OSAHS patients, steps walked daily were correlated positively with FOSQ scores but negatively with BMI, ESS scores, AHI, oxygen desaturation index ( ODI) and saturation impair time below 90% ( SIT90) ( P lt; 0.05) . After one month of nCPAP therapy, ESS scores were significantly decreased, FOSQ scores and steps walked daily were significantly increased (Plt;0.05) . Conclusions Increased OSAHS severity is associated with decreased steps walked daily which is an objective index of routine physical activity. Untreated OSAHS may negatively impact the patients’ability to have an active lifestyle. nCPAP therapy can significantly improve steps walks daily of patients with OSAHS.
【Abstract】 Objective To study the effects of obstructive sleep apnea hypopnea syndrome ( OSAHS) on blood pressure variations, and explore the possible mechanism. Methods 84 adult patients ( mean age 50. 1 ±14. 8 years, male /female 67 /17) were recruited for polysomnography ( PSG) and ambulatory blood pressure monitoring. Four groups were identified based on apnea hyponea index ( AHI) ,ie. non-OSAHS group ( n=9) ,mild group ( n=19) , moderate group ( n=23) , and severe group ( n =33) .The blood pressure levels were compared among the four groups. Correlations between PSG indexes,variations of systolic blood pressure ( SBP) and diastolic blood pressure ( DBP) were analyzed. Results Inter-group blood pressure comparison showed significant differences in SBP and DBP( P lt;0. 05) , except forthe mild and the moderate OSAHS patients. As compared with the non-OSAHS patients, SBP for those with severe OSAHS was about 15 mm Hg higher, and DBP 10 mm Hg higher. Observation on SBP non-dipping rate indicated that, except for the mild and the moderate OSAHS patients where no significant differences were found, SBP non-dipping rate increased with the severity of OSAHS( the rates were 78. 3%, 57. 1% ,54. 5%, and 32. 6% , respectively for the four groups) , whereas DBP non-dipping rate significantly increased in the severe OSAHS patients( 54. 3% ) ( P lt;0. 05) . For the mild OSAHS patients, blood pressure was found to be correlated positively with the body mass index ( correlation coefficient for day time SBP was 0. 26, and for DBP was 0. 22) , the arousal index ( correlation coefficient for day time SBP was 0. 25, and for DBP was 0. 17) , and heart rate variation ( correlation coefficient for night time SBP was 0. 18, and for DBP was 0. 17) . For the moderate OSAHS patients, a positive correlation was also found between blood pressure and AHI ( correlation coefficient for day time SBP was 0. 31, and for DBP was 0. 22, correlation coefficient fornight time SBP was 0. 26) , and between blood pressure and the longest hypopnea time during sleep ( LH) ( correlation coefficient for night time DBP was 0. 2) . For the severe OSAHS patients, blood pressure was correlated positively with apnea index ( AI) ( correlation coefficient for day time SBP was 0. 61, and for DBP was 0. 5, correlation coefficient for night time SBP was 0. 57 and for night time DBP was 0. 48) . Conclusions OSAHS has ber impact on SBP than on DBP. DBP hypertension and SBP non-dipping are usually found in early OSAHS-affected patients. Factors affecting blood pressure differ with the severity of the OSAHS.
Objective To investigate the relatingship between leptin receptor gene Gln223Arg polymorphism and obstructive sleep apnea hyponea syndrome (OSAHS) in Han population in Southwest China. Methods Two hundred and fifteen cases of subjects (including 116 cases in OSAHS group and 99 cases in control group) were selected in Han population in Southwest China. Polymerase chain reaction (PCR) was used to analyse Gln223Arg leptin receptor gene polymorphism. The levels of serum LEP and TI were determined by double antibody sandwich enzyme-linked immunosorbent assay (ELISA). Simultaneous determination of body mass index (BMI) and neck circumference (NC) and waist circumference (WC) were conducted. Results In the OSAHS group, the leptin receptor gene polymorphism Gln223Arg GG, AA and GA genotype frequency was 0.854, 0.017 and 0.129, respectively. G allele and A allele frequency frequency was 0.918 and 0.082, respectively. In the control group, leptin receptor gene polymorphisms Gln223Arg GG, AA and GA genotype frequency was 0.840, 0.020 and 0.14,respectively. G allele and A allele frequency was 0.90 and 0.10, respectively. Genotype frequencies of the two groups were not statistically significant (χ2=0.784, P>0.05). There were differences in BMI, WC and NC between the OSAHS patients with GG and the OSAHS patients with (GA+AA) genotype (P<0.05), but no difference was found in LEP and TI levels (allP>0.05). In control, mild, moderate and severe OSAHS group, the levels of serum LEP and TI were increased gradually, and the difference was statistically significant (allP<0.05). Conclusions Gln223Arg leptin receptor genotype polymorphisms may be involved in obesity, but they have no relationship with the incidence of OSAHS in Han population in Southwest China. In OSAHS patients, Gln223Arg polymorphism has no relationship with LEP or TI. Patients with OSAHS have hyperleptinemia and hyperinsulinemia.
Objective To explore the relationship between uric acid (UA) level and cardiovascular disease in patients with OSAHS and its clinical significance. Methods The electronic medical record system of the First hospital of Lanzhou University was used to collect 475 subjects who completed polysomnography (PSG) during hospitalization from January 2019 to May 2020. According to the Guidelines for the Diagnosis and Treatment of Obstructive Sleep Apnea Hypopnea Syndrome (Basic Version), the patients were divided into four group: control group [apnea-hypopnea index (AHI) <5 times/h, n=96], mild group (5≤AHI≤15 times/h, n=130), moderate group (15<AHI≤30 times/h, n=112), and severe group (AHI>30 times/h, n=137). The age, gender, body mass index (BMI), smoking history, drinking history, hypertension, diabetes mellitus, cardiovascular disease and biochemical indexes [including triglyceride, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, glucose, UA, blood urea nitrogen (BUN), serum creatinine, lactate dehydrogenase, homocysteine], PSG indexes were observed and compared among the four groups, and the differences were compared by appropriate statistical methods. Binary logistic regression model was used to evaluate the correlation between various risk factors and cardiovascular disease. Results There were statistically significant differences in age, gender, BMI, drinking history, hypertension and cardiovascular disease among the 4 groups (P<0.05). The levels of UA and BUN in mild, moderate and severe groups were higher than those in the control group, with statistical significance (P<0.05). With the increasing of OSAHS severity, the level of UA increased. There was statistical significance in the incidence of cardiovascular disease among the four groups (P<0.05), and the highest incidence of arrhythmia was found among the four groups. And the incidence of cardiovascular disease increases with the increasing of OSAHS severity. Binary Logistic regression analysis showed that the risk factors for cardiovascular disease in OSAHS patients were age, UA and BUN (P<0.05). Conclusions The occurrence of cardiovascular disease in OSAHS patients is positively correlated with the severity of OSAHS. The level of UA can be used as an independent risk factor for cardiovascular disease in OSAHS patients. Therefore, reducing the level of UA may have positive significance for the prevention and control of the prevalence and mortality of cardiovascular disease in OSAHS patients.
ObjectiveTo systematically review the association between the level of plasma YKL-40 and obstructive sleep apnea hypopnea syndrome (OSAHS).MethodsWe searched PubMed, EMbase, MEDLINE, CNKI, WanFang Data, VIP database and supplemented by Google academic retrieval to collect case-control studies about the association between the level of plasma YKL-40 and OSAHS from inception to April 2017. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of included studies. And then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 5 case-control studies were included, involving 755 OSAHS patients and control population. The results of meta-analysis showed that the level of plasma YKL-40 in OSAHS patients was higher than that in control group (SMD=1.20, 95%CI 0.33 to 2.06, P=0.007). The subgroup analysis showed that the level of plasma YKL-40 in OSAHS patients from Asia was significantly higher than that in control group (SMD=1.79, 95%CI 0.83 to 2.75, P=0.000 2). The comparison between different severity of OSAHS showed that the wild-medium group had lower plasma level of YKL-40 than the severe group (SMD=–0.83, 95%CI –1.46 to –0.19, P=0.01).ConclusionYKL-40 may play an important role in the pathogenesis of OSAHS. Due to limited quantity and quality of the included studies, more high quality studies are needed to verify above conclusions.
Objective To investigate the role of red cell distribution width ( RDW) in coronary artery diseases patients complicated with obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods 134 coronary artery diseases patients who had at least one-vessel disease confirmed by coronary angiography were investigated by polysomnography for OSAHS. The patients were classified according to theapneahypopnea index(AHI) . The level of RDW, triglyceride, cholesterol, high density lipoprotein, low density lipoprotein, hemoglobin, white blood cells and hematocritwere measured. The receiver operating characteristic curve was drawn to predict the moderate-severe OSAHS in coronary artery diseases patients according to RDW value. Results When 134 coronary artery diseases patients were classified into a control group and an OSAHS group according to the AHI, the level of RDW in two groups was not significantly different [ ( 13.44 ±1.30) % vs. ( 13.12 ±0.92) % , P gt; 0.05] . When 134 coronary artery diseases patients were classified into a control and mild OSAHS group and a moderate-severe OSAHS group according to the AHI, the level of RDW in two groups was significantly different [ ( 13.07 ±0.94) vs. ( 14.02 ±1.41) % , P lt; 0.05] . And no difference was found in hemoglobin, triglyceride, cholesterol, high density lipoprotein, low density lipoprotein, platelet, and hematocrit between two groups. The ROC curve analysis revealed that the area under ROC curve was 0.748 ( 0.523-0.972) , and the best cut-off for moderate-severe OSAHS was 13.95% with sensitivity of 71.43% and specificity of 82.98% . Conclusion RDW may be a useful and simple tool to predict moderate-severe OSAHS in coronary artery diseases patients.
Objective To analyze the causes of missed diagnosis of sleep apnea hypopnea syndrome ( SAHS) . Methods 42 missed diagnosed cases with SAHS from May 2009 to May 2011 were retrospectively analyzed and related literatures were reviewed. Results The SAHS patients often visited the doctors for complications of SAHS such as hypertension, diabetes mellitus, metabolic syndrome, etc. Clinical misdiagnosis rate was very high. Lack of specific symptoms during the day, complicated morbidities, and insufficient knowledge of SAHS led to the high misdiagnosis rate and the poor treatment effect of patients with SAHS. Conclusion Strengthening the educational propaganda of SAHS, detail medical history collection, and polysomnography monitoring ( PSG) as early as possible can help diagnose SAHS more accurately and reduce missed diagnosis.
Objective To investigate the implication of oxidation protein product ( advanced oxidation protein product, AOPP) , an index of oxidative stress in obstructive sleep apnea-hypopnea syndrome ( OSAHS) . Methods 47 patients with OSAHS and 48 normal controls were enrolled. The concentration of AOPP was measured by spextrophotometry after ameliorated, while superoxide ( SOD) , malonaldehyde ( MDA) , glutathione peroxidase ( GSH-PX) in morning blood samples were detected by Xanthine oxidase test. Results ( 1) Plasma AOPP and MDA were significantly elevated in OSAHS compared with those in control group ( both P lt;0. 01) . Plasma SOD and GSH-PX were significantly lower in OSAHS compared with those in control group ( both P lt;0. 01) . There were significant differences in the plasma AOPP, MDA, SODand GSH-PX among different severity of OSAHS ( all P lt; 0. 01) . Plasma AOPP and MDA were increased and SOD and GSH-PX were gradually decreased with the progression of OSAHS. ( 2) Plasma AOPP correlated well with MDA, SOD and GSH-PX, moreover, AOPP was positively correlated with apnea hyponea index or lowest oxygen saturation. Conclusion AOPP is an alternative index reflecting both oxidative streess and tissue injury in patients with OSAHS.
This study seeks to explore the early signs of cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). According to polysomnography, twenty patients diagnosed with OSAHS and twenty normal controls underwent event-related potential (ERP) examination including mismatch negativity (MMN) and P300. Compared with normal controls, OSAHS patients showed significantly prolonged latency of MMN and P300 at Cz. After controlling age and body mass index (BMI), MMN latency positively correlated with apnea hypopnea index (AHI), oxygen reduction index, stage N1 sleep and arousal index, while MMN latency negatively correlated with stage N3 sleep and mean blood oxygen saturation; and P300 latency positively related to AHI and oxygen reduction index; no relationships were found among MMN latency, MMN amplitude, P300 latency and P300 amplitude. These results suggest that the brain function of automatic processing and controlled processing aere impaired in OSAHS patients, and these dysfunction are correlated with nocturnal repeatedly hypoxemia and sleep structure disturbance.