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目的测定阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者呼出气凝集液(EBC)中的过氧化氢(H2O2)浓度,观察其改变及与病情程度的相关性。方法收集EBC 42份,其中OSAHS患者32份(吸烟者18份,非吸烟者14份),非OSAHS对照组10份。荧光法测定睡前和晨起EBC中的H2O2浓度。结果OSAHS组患者睡前EBC中H2O2浓度与对照组比较差异无统计学意义(F= 0．01,P=0．99)。晨起EBC中H2O2浓度OSAHS不吸烟组和吸烟组分别为(1．82±1．12)、(1．65±0．89)μmol／L,较对照组(0．71±0．36)μmol／L明显增高(F=5．11,P=0．01)。其浓度亦分别较睡前[(0．87±0．45)、(0．88±0．36)μmol／L]升高(t分别为2．95、3．43,P均<0．01)。对照组睡前[(0．86±0．46)μmol／L]和晨起[(0．71±0．36)μmol／L]差异无统计学意义(t=0．81,P=0．43)。晨起EBC中H2O2浓度与夜间最低血氧饱和度(SpO2min)呈负相关(β=-0．36,P=0．02),晨起与睡前H2O2浓度变化的差值亦与SpO2min呈负相关(β=-0．38,P=0．01)。结论OSAHS患者由于夜间反复出现缺氧-再氧和,呼吸道局部氧应激反应在晨起增加。
Objective To determine the concentration of hydrogen peroxide (H2O2) in exhaled air condensate (EBC) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and to observe the changes and the correlation with the severity of the disease. Methods 42 patients with EBC were collected, including 32 OSAHS patients (18 smokers, 14 non-smokers) and 10 non-OSAHS controls. Fluorescence method to measure the concentration of H2O2 in EBC before going to bed and early morning. Results Compared with the control group, there was no significant difference in the concentration of H2O2 before bedtime in patients with OSAHS (F = 0.01, P = 0.99). Compared with the control group (0.71 ± 0.36), the H2O2 concentration of EBC in OSAHS group was (1.82 ± 1.12) and (1.65 ± 0.89) μmol / L respectively, μmol / L was significantly higher (F = 5.11, P = 0.01). Their concentrations were also higher than those before bedtime [(0.87 ± 0.45), (0.88 ± 0.36) μmol / L] (t = 2.95,3.43, P <0. 01). There was no significant difference between the control group before bedtime [(0.86 ± 0.46) μmol / L] and early morning [(0.71 ± 0.36) μmol / L] (t = 0.81, P = .43). The concentration of H2O2 in EBC was negatively correlated with the lowest oxygen saturation (SpO2min) in the morning (β = -0.36, P = 0.02). The difference between the morning and evening before sleep was also negative with SpO2min (Β = -0.38, P = 0.01). Conclusions Oxygen reoxygenation occurs repeatedly in patients with OSAHS, and the local respiratory response to oxygen stress increases in the morning.