vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1814-6023-2020-17-3-329-336vestim-692Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEСиндром обструктивного апноэ во сне: функциональное состояние эндотелия сосудов и особенности мозговой гемодинамикиObstructive sleep apnea syndrome: functional state of vascular endothelium and features of brain hemodynamicsЮшкевичЕ. К.YushkevichE. K.

Юшкевич Елена Константиновна ‒ аспирант, заведующий отделением

ул. Кижеватова, 58, 220024, г. Минск

Elena K. Yushkevich ‒ Postgraduate student, Head of the Department

Lieutenant Kizhevatov Str., 58, 220024, Minsk

apricurl@gmail.comМитьковскаяН. П.MitkovskayaN. P.

Митьковская Наталья Павловна ‒ доктор медицинских наук, профессор, заведующий кафедрой

пр. Дзержинского, 83, 220116, г. Минск

Natalya P. Mitkovskaya ‒ D. Sc. (Med.), Professor, Head of the Department

83, Dzerzhynskii Ave., 220116, Minsk

mitkovskaya1@mail.ruГригоренкоЕ. А.GrigorenkoE. A.

Григоренко Елена Александровна ‒ кандидат медицинских наук, доцент, профессор

пр. Дзержинского, 83, 220116, г. Минск

Elena A. Grigorenko ‒ Ph. D. (Med.), Assistant Professor, Professor

83, Dzerzhynskii Ave., 220116, Minsk

alegri@tut.byГородская клиническая больница скорой медицинской помощиMinsk City Emergency HospitalБелорусский государственный медицинский университетBelarusian State Medical University202029082020173329336Copyright © Юшкевич Е.К., Митьковская Н.П., Григоренко Е.А., 20202020Юшкевич Е.К., Митьковская Н.П., Григоренко Е.А.Yushkevich E.K., Mitkovskaya N.P., Grigorenko E.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/692

Цель исследования ‒ выявить связь между показателями функционального состояния эндотелия сосудов и регионального мозгового кровотока у лиц трудоспособного возраста со средней и тяжелой степенью синдрома обструктивного апноэ во сне. Проведено поперечное проспективное обсервационное исследование, включавшее 24 человека, из которых 16 пациентов трудоспособного возраста с диагнозом синдрома обструктивного апноэ во сне (СОАС) средней и тяжелой степени вошли в основную группу исследования, а 8 человек, не имевших нарушений по данным полисомнографии, – в группу контроля. Определены уровни биохимических маркеров дисфункции эндотелия, показатели эндотелийзависимой вазодилатации плечевой артерии, выполнена однофотонная эмиссионная компьютерная томография головного мозга с использованием 99мТс-гексаметилпропиленаминоксима. Установлено, что у пациентов трудоспособного возраста с СОАС средней и тяжелой степени достоверно более низкие среднегрупповые значения сывороточного уровня оксида азота (11,7 (6,25‒18,30) мкмоль/л против 34,4 (25,33‒41,70) мкмоль/л в группе контроля, p  < 0.01), более высокие концентрации гомоцистеина (19,4 (15,13‒ 23,76) мкмоль/л против 11,6 (6,40‒14,71) мкмоль/л в группе контроля, р < 0,05), sP-селектина 176 (142,0‒189,0) нг/мл против 122 (113,3‒168,5) нг/мл в группе контроля, р <  0,05) и sE-селектина (78 (69,0‒121,0) нг/мл против 52 (43,1‒73,3) нг/мл в группе контроля, р < 0,05). Получены данные о корреляции уровня нейрогуморальных маркеров дисфункции эндотелия sP-селектина (р < 0,01) и sE-селектина (р < 0,05) со степенью нарушения регионального мозгового кровотока. Выявлена прямая связь между маркерами эндотелийзависимой вазодилатации и показателями регионального мозгового кровотока в лобных сегментах (р < 0,05), височном сегменте справа (р <  0,05).

The aim of the study is to identify the relationships between the functional state of vascular endothelium and regional cerebral blood flow in people of working age with moderate to severe obstructive sleep apnea syndrome. A transverse prospective observational study was conducted. It included 24 patients. Among them were 16 patients of working age with moderate to severe obstructive sleep apnea syndrome who were included in the main study group and 8 patients without sleep disorders in the control group according to polysomnography. The levels of biochemical markers of endothelial dysfunction, the indicators of endothelium-dependent vasodilation of the brachial artery were determined. Single-photon emission computed tomography of the brain was performed using 99mTc-hexamethylpropyleneaminoxime. In the patients of working age with moderate to severe obstructive sleep apnea syndrome, significantly lower average group values of the serum nitric oxide level of 11.7 (6.25‒18.30) μmol/l were detected versus 34.4 (25.33‒41.70) μmol/l in the control group, p  < 0.01), as well as higher homocysteine concentrations of 19.4 (15.13‒23.76) μmol/l versus 11.6 (6.40‒ 14.71) μmol/l in the control group, p < 0.05, sP-selectin 176 (142.0‒189.0) ng/ml versus 122 (113.3‒168.5) ng/ml in the control group, p < 0.05, and sE β-selectin 78 (69.0‒121.0) ng/ml versus 52 (43.1‒73.3) ng/ml in the control group, p < 0.05. The data on the correlation of the level of neurohumoral markers of endothelial dysfunction of sP-selectin (p <  0.01) and sE-selectin (p < 0.05) with the degree of impaired regional cerebral blood flow were obtained. A direct relationship was found between the markers of endothelium-dependent vasodilation and regional cerebral blood flow in the frontal segments (p < 0.05), the temporal segment on the right (p < 0.05).

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The authors declare that there are no conflicts of interest present.