阻塞性睡眠呼吸暂停综合征患者血炎症因子水平与动脉粥样硬化相关性及干预治疗的研究

发布时间：2018-12-30 19:21

【摘要】：目的探讨阻塞性睡眠呼吸暂停综合征(OSAS)患者血炎症因子与动脉粥样硬化的关系。方法选取就诊的OSAS患者60例,分为轻度组20例,中度组20例,重度组20例,另选对照组20例。对其中OSAS组中40例中重度患者进行持续气道正压通气(CPAP)治疗,并检测治疗前后颈动脉内中膜厚度(IMT)、肱—踝脉搏波传导速度(ba PWV)以及血炎症因子(IL-18、TNF-α、hs-CRP、ICAM-1、VCAM-1、E选择素和P选择素)水平的差异作统计学处理。结果 OSAS组的血炎症因子水平明显高于对照组,且OSAS各组间均有明显差异(均P0.05)。血炎症因子水平与颈动脉IMT、呼吸暂停低通气指数(AHI)、ba PWV呈正相关(P0.01),与最低脉搏氧饱和度(Sp O2)呈负相关(P0.01)。CPAP治疗后OSAS患者血炎症因子水平、IMT以及ba PWV均有下降。结论 OSAS患者颈动脉IMT增厚、ba PWV增快与血炎症因子水平增高显著相关。血炎症因子水平升高与OSAS严重程度相关,动脉粥样硬化的进展可能与OSAS相关的炎症反应有关。CPAP治疗能够改善患者AHI以及Sp O2,降低血炎症因子水平。
[Abstract]:Objective to investigate the relationship between serum inflammatory factors and atherosclerosis in patients with obstructive sleep apnea syndrome (OSAS). Methods 60 patients with OSAS were divided into mild group (n = 20), moderate group (n = 20), severe group (n = 20) and control group (n = 20). In the OSAS group, 40 patients with moderate and severe airway pressure were treated with continuous positive airway pressure (CPAP). The carotid intima-media thickness (IMT), brachial-ankle pulse wave velocity (ba PWV) and serum inflammatory factor (IL-18,) were measured before and after treatment. The levels of TNF- 伪, hs-CRP,ICAM-1,VCAM-1,E selectin and P selectin were statistically analyzed. Results the levels of serum inflammatory factors in OSAS group were significantly higher than those in control group, and there were significant differences among OSAS groups (P0.05). The level of serum inflammatory factor was positively correlated with (AHI), ba PWV of carotid IMT, apnea hypopnea index (P0.01) and negatively correlated with minimum pulse oxygen saturation (Sp O2). Both IMT and ba PWV decreased. Conclusion the thickening, ba PWV of carotid IMT in patients with OSAS is significantly correlated with the increase of serum inflammatory factors. The increase of serum inflammatory factor level is related to the severity of OSAS, and the progression of atherosclerosis may be related to the inflammatory reaction associated with OSAS. CPAP treatment can improve AHI and Sp O 2, and decrease the level of serum inflammatory factor.
【作者单位】：南京医科大学附属江宁医院呼吸内科;南京医科大学第一附属医院呼吸内科;
【基金】：江苏省卫生厅科研项目(YG201401)
【分类号】：R766;R543.5

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