阻塞性睡眠呼吸暂停低通气综合征对高血压患者血栓前状态的影响

发布时间：2018-01-30 10:03

本文关键词： 阻塞性睡眠呼吸暂停低通气综合征睡眠呼吸暂停低通气指数血栓前状态　出处：《广东医学》2014年07期 　论文类型：期刊论文

【摘要】：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对原发性高血压(EH)患者血栓前状态指标的影响。方法选择就诊经多导睡眠监测(PSG)的高血压患者,诊断EH+OSAHS者65例,单纯EH者68例。进行血栓前状态指标检测,对比两组患者血栓前状态指标凝血酶时间(TT)、血浆凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、CD62p、CD63、D-二聚体、纤维蛋白原(Fg)的变化。结果 (1)与单纯EH者相比,EH+OSAS者中最低SaO2[(73.5±5.8)%vs(92.1±2.3)%,P=0.010]显著减低,SaO290%(%TST)(26.9±1.7 vs0±0,P=0.003)明显增加,差异有统计学意义。(2)EH+OSAS患者TT[(14.62±1.27)s vs(16.31±1.36)s]、PT[(11.9±0.85)s vs(12.8±0.74)s]、APTT[(34.15±3.57)s vs(37.26±4.23)s]较单纯EH者明显缩短,而CD62p[(5.71±0.48)%vs(3.62±0.53)%]、CD63[(5.37±0.46)%vs(3.30±0.50)%]、D-二聚体[(0.94±0.67)mg/L vs(0.41±0.16)mg/L]、Fg[(3.52±0.65)g/L vs(3.02±0.62)g/L]明显高于单纯EH者,差异均有统计学意义(P0.05)。(3)EH+OSAH患者睡眠呼吸暂停低通气指数(AHI)与TT、PT、APTT无相关性,而与CD62p、CD63、D-二聚体、Fg呈正相关(r=0.305、0.268、0.247、0.281,均P0.05)。结论作为血栓前状态指标TT、PT、APTT、CD62p、CD63、D-二聚体、Fg,EH+OSAH患者血小板活性增加、纤维蛋白原增加以及其他血栓形成的危险因素明显,而且与睡眠呼吸暂停的严重程度相关,是OSAH伴发心脑血管栓塞性疾病的高危状态。
[Abstract]:Objective to investigate the effect of obstructive sleep apnea hypopnea syndrome (OSAHS) on prethrombotic state in patients with essential hypertension (EH). In patients with high blood pressure. 65 cases of EH OSAHS and 68 cases of simple EH were diagnosed. Plasma prothrombin time (PTT) and activated partial prothrombin time (APTTT) were observed. The change of fibrinogen (FG). Results 1) the lowest SaO2 of EH OSAS was found in EH patients compared with EH patients. [(73.5 卤5.8 vs 92.1 卤2.3 vs 0.010) significantly decreased SaO290 (26.9 卤1.7 vs0 卤0). P0. 003) (P < 0. 003). The difference is statistically significant. TTT in patients with EH OSAS. [14. 62 卤1. 27 s vs(16.31 卤1. 36 s] PT. [11. 9 卤0. 85 vs(12.8 卤0. 74 s. [34. 15 卤3. 57 vs(37.26 卤4. 23 s] was significantly shorter than that of EH alone, while CD62p was significantly shorter than that of EH alone. [CD63: 5.71 卤0.48% vs 3.62 卤0.53%. [5. 37 卤0. 46 VSM 3.30 卤0. 50%] D- dimer. [0. 94 卤0. 67 mg / L vs(0.41 卤0. 16 mg / L] FG. [3.52 卤0.65 g / L vs(3.02 卤0.62g / L] was significantly higher than that of EH alone. The difference was statistically significant (P 0.05). There was no correlation between the sleep apnea hypopnea index (AHII) and CD62p in patients with OSAH. CD63 D- dimer Fg was positively correlated with 0.305 ~ 0.268 ~ 0.247 ~ 0.281, all of which were P0.05.Conclusion as a pre-thrombotic index, TTT _ (PT) can be used as an index of prethrombotic status. The platelet activity, fibrinogen and other risk factors of thrombogenesis were significantly increased in patients with APTTT CD62pnCD63D- dimer OSAH. And it is associated with the severity of sleep apnea and is a high risk state of OSAH with cardiovascular and cerebrovascular embolism.
【作者单位】：徐州医学院附属淮安医院心内科;
【基金】：江苏省卫生厅科技项目(编号:Z200913)
【分类号】：R766;R544.11
【正文快照】： 阻塞性睡眠呼吸暂停低通气综合征(obstructivesleep apnea-hypopnea syndrome,OSAHS)是一种临床常见的睡眠呼吸障碍性疾病,引起内皮细胞功能紊乱,纤维蛋白原、纤溶酶原激活抑制物增加,纤溶活力下降,血小板功能活化,是原发性高血压(EH)、冠心病、心肌梗死及脑卒中等发病的独立

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