阻塞性睡眠呼吸暂停低通气综合征患者血液流变学的变化及其意义

发布时间：2018-08-06 18:25

【摘要】：目的探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者血液流变学的变化及其临床意义。方法选择OSAHS患者40例和健康对照组20例,行血液流变学检查和多导睡眠监测,血液流变学指标包括:红细胞压积(Hematocrit,HCT)、全血黏度(高切变率、中切变率、低切变率)、红细胞聚集指数、血浆粘度、纤维蛋白原浓度。多导睡眠监测(Polysomno-graphy,PSG)指标包括:体重指数(Body Mass Index,BMI)、睡眠呼吸暂停低通气指数(Apnea Hypopnea Index,AHI)、最低血氧饱和度(Lowest Blood Oxygen,LSaO2)、平均血氧饱和度(Mean Blood Oxygen,MSaO2)及血氧饱和度90%时间占总睡眠时间百分比(Spent Time Percent of Blood Oxygen Bline 90%,STPSaO290%)。根据AHI的结果将OSAHS组分为轻度组(15例)、中度组(12例)、重度组(13例)比较各组间血液流变学指标变化。结果1.对照组与轻度OSAHS组比较,中度组与重度OSAHS组比较血液流变学指标无明显差异,与轻度OSAHS组比较,中度和重度OSAHS组全血粘度、HCT和红细胞聚集指数均有显著性差异(P0.05);而血浆粘度和纤维蛋白原浓度无统计差异学。2.与对照组比较,重度OSAHS组BMI明显增高,差异有统计学意义(P0.01);与对照组比较,中度、重度OSAHS组LSa02、MSa02均有显著性差异(P0.05),STPSaO290%有显著性差异(P0.01);与轻度OSAHS组比较,重度OSAHS组LSaO2、MSaO2及STPSaO290%均有显著性差异(P0.01);对照组、轻度、中度、重度OSAHS组两两比较,AHI有显著性差异(P0.01)。3.全血粘度、红细胞聚集指数、HCT与AHI及STPSaO290%均呈正相关;与LSaO2和MSaO2呈负相关(P0.05),而与BMI无相关性。结论1.OSAHS患者存在血液流变学异常,存在高粘血症。2.OSAHS患者血液流变学异常与睡眠结构紊乱、睡眠呼吸暂停、血氧饱和度降低有关。
[Abstract]:Objective to investigate the changes of hemorheology in patients with obstructive sleep apnea hypopnea syndrome (obstructive sleep apnea-hypopnea syndrome) and its clinical significance. Methods 40 patients with OSAHS and 20 healthy controls were examined with hemorheology and polysomnography. The indexes of hemorheology included hematocrit (HCT), whole blood viscosity (high shear rate, middle shear rate). Low shear rate), erythrocyte aggregation index, plasma viscosity, fibrinogen concentration. Polysomnography included body mass index (Body Mass), sleep apnea hypopnea index (Apnea Hypopnea index), minimum oxygen saturation (Lowest Blood Oxygena L SaO2), mean oxygen saturation (Mean Blood Oxygena MSaO2) and blood oxygen saturation (90% of total sleep time). This is 290.0% higher than (Spent Time Percent of Blood Oxygen Bline 90. According to the results of AHI, the OSAHS group was divided into mild group (15 cases), moderate group (12 cases) and severe group (13 cases). Result 1. There was no significant difference in hemorheology between moderate group and severe OSAHS group, but there was no significant difference between mild OSAHS group and mild OSAHS group. There were significant differences in whole blood viscosity and erythrocyte aggregation index between moderate and severe OSAHS groups (P0.05), but there was no statistical difference in plasma viscosity and fibrinogen concentration. 2. Compared with the control group, the BMI of the severe OSAHS group was significantly higher than that of the control group (P0.01), and that of the moderate and severe OSAHS group was significantly higher than that of the control group (P0.05), and that of the severe OSAHS group was 290.0% (P0.01), and that of the mild OSAHS group was higher than that of the mild OSAHS group. There was significant difference in MSaO2 and STP SaO2 between severe OSAHS group and control group (P0.01), and significant difference in control group, mild, moderate and severe OSAHS group (P0.01). The whole blood viscosity and erythrocyte aggregation index were positively correlated with AHI and STP Sao 290.0%, but negatively correlated with LSaO2 and MSaO2 (P0.05), but not with BMI. Conclusion the abnormal hemorheology and hyperviscosity in 1.OSAHS patients are related to the disorder of sleep structure, sleep apnea and the decrease of blood oxygen saturation.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R766

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