OSAHS和CHD发病率与GMP-140、D-二聚体变化的相关性  

The ralation of plasma GMP-140, D-dimer levels and incidence of OSAHS and/or CHD

作　　者：冯笑梅[1] 刘喜[1] 冀虎岗[1] 

机构地区：[1]内蒙古自治区医院,呼和浩特010017

出　　处：《实验与检验医学》2007年第6期555-556,564,共3页Experimental and Laboratory Medicine

摘　　要：目的了解血浆GMP-140、D-二聚体在重度阻塞型睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者和冠心病(coronary heart disease,CHD)患者体内浓度的变化,探讨OSAHS患者CHD发病率增高的机制。方法对重度OSAHS组18例、CHD组22例、OSAHS合并CHD组12例和健康对照组20例应用酶联免疫吸附法(ELISA)检测血浆中GMP-140与D-二聚体浓度,应用统计学方法处理数据。结果OSAHS组、CHD组和OSAHS合并CHD组(合并组)血浆GMP-140浓度分别为(18.84±1.99)ng/ml、(18.82±1.59)ng/ml和(18.88±1.79)ng/ml,与正常对照组(12.79±1.32)ng/ml有明显差异(P<0.05);三组的D-二聚体浓度分别为(0.43±0.003)mg/L、(0.50±0.001)mg/L、(0.50±0.004)mg/L,均显著高于健康对照组(0.22±0.001)mg/L(P<0.05)。而OSAHS组、CHD组和合并组之间GMP-140浓度、D-二聚体浓度相比较无明显差异(P>0.05)。且GMP-140与D-二聚体浓度呈正相关,相关系数γ=0.69,P<0.05。结论重度OSAHS患者因乏氧体内存在血管内皮(包括冠脉内皮)损伤、血小板活化、凝血系统激活和继发性纤溶系统功能亢进,这些可能是OSAHS患者CHD的发生、发展机制。Objective To evaluate the changes of the plasma levels of GMP-140 andD-dimer in patients with Obstructive sleep apnea-hypopnea syndrome(OSAHS) or and Coronary heart disease (CHD), and to discuss the cause of higher morbidity of the patients. Methods Plasma GMP-140 and D-dimer levels 18 severe OSAHS patients, 22 CHD patients, 12 combined OSAHS with CHD patients, 20 controls, were measured by enzyme-linked immunosorbent assay(ELISA). Results In OSAHS group, CHD group, and combined OSAHS with CHD group, the plasma levels of GMP-140 were 18.84±1.99ng/ml, 18.82±l.59ng/ml, 18.88±1.79ng/ml respectively. The value of the control group was 12.79±1.32ng/ml. there was significant difference between the patientgroup and control group(P<0.05). The levels of D-dimer in three patient groups were 0.43±0.003mg/L, 0.50±0.001ml/L, 0.50±0.004mg/l respectively, which were significantly higher than that of the control group(P<0.05). The level of GMP-140 and level of D-dimer had no significant difference between three patient groups (P>0.05). Conclusions With lack of oxygen, the OSAHS patient coronary artery endothelial damage and platelet activation, suffered activated coagulation system combined with hyperfibrinolysis. It may lead to CHD.

关 键 词：阻塞型睡眠呼吸暂停低通气综合征 冠心病 a-颗粒膜蛋白 D-二聚体 

分 类 号：R446.61[医药卫生—诊断学] R541.4[医药卫生—临床医学]