Objective: To investigate the clinical value of continuous positive airway pressure(CPAP) combined with N-acetyl cysteine(NAC) atomization in the treatment of moderate to severe obstructive sleep apnea(OSA) and its effect on the expression of HIF-1α, ET-1 and NO in peripheral blood of OSA patients. Methods: 125 patients with moderate to severe OSA, 120 with mild OSA, and 120 healthy subjects were recruited from December 2019 to August 2021 visited in our hospital. Moderate to severe OSA was divided into NAC group, CPAP group and combination groups. All enrollees underwent polysomnography(PSG) monitoring and sleep apnea quality of life index(SAQLI) scale assessment. Peripheral blood samples of each group were collected, and serum HIF-1α and plasma ET-1 concentrations were measured by enzyme-linked immunosorbent assay, and plasma NO concentration was measured by nitrate reductase assay. Results: The apnoea hypopnea index(AHI) after treatment of the combination group decreased more significantly than that of the CPAP group(P<0.05). For the single item score of daily activities and symptoms, and the total score, the rate of improvement in the combination group were significantly higher than those in the CPAP group(P<0.05).Both HIF-1α and ET-1 levels were positively correlated with AHI values in moderate to severe OSA(r=0.832, P<0.05; r= 0.795, P<0.05), and NO levels were negatively correlated with AHI values(r=-0.792, P<0.05).The expression levels of HIF-1α and ET-1 in the combined group decreased more significantly than those in NAC group and CPAP group(P<0.05), while the expression of NO increased more significantly(P<0.05). Conclusion: CPAP combined with NAC atomization therapy can improve the clinical efficacy and the quality of life of patients with moderate to severe OSA, and it may improve vascular endothelial injury in moderate to severe OSA. |
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