手术对阻塞性睡眠呼吸暂停低通气综合征患者血栓形成机制的影响  

Effect of Operation on Thrombosis Mechanism in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

作　　者：阳光[1] 姚行齐[1] 杨长亮[1] 孙艺[1] 褚勇[1] 罗燕云[1] 

机构地区：[1]广州军区武汉总医院耳鼻喉科,武汉430070

出　　处：《华南国防医学杂志》2006年第4期13-15,共3页Military Medical Journal of South China

摘　　要：目的探讨重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患血栓形成机制及手术对其影响。方法选择经多导睡眠监测(PSG)确诊的重度OSAHS患者54例为OSAHS组,并设正常对照组20例,检测两组血浆P-选择素,组织型纤溶酶原激活物(t-PA)水平。并比较OSAHS组手术后半年上述指标的差异。结果①OSAHS组血浆P-选择素高于对照组(P<0.05)而t-PA活性低于对照组(P<0.05);(②OSAHS组手术后半年较术前上述各指标均有显著性差异(P<0.05);③P-选择素与呼吸紊乱低通气指数(AHI)呈正相关,与最低血氧饱和度(SaO2min)呈负相关(P<0.05),t-PA活性与AHI呈负相关,与SaO2min呈正相关(P<0.05)。结论OSAHS患者存在血小板活化,凝血激活及纤溶活性下降,并与夜间低氧血症密切相关,手术可有效逆转上述改变。Objective To explore the mechanism of thrombosis and the effect of operation on it in patients with obstructive sleep apnea-hypophea syndrome （OSAHS）. Methods Fifty -four patients with OSAHS confirmed by polysomnography （PSG） served as the OSAHS group and 20 normal donors without OSAHS served as the control group. The plasma levels of P-selectin and t-PA were detected in both the groups. Results The plasma levels of P-selectin was significantly higher in the OSAHS group than that in the control group （ P 〈0.05 ）, and the activity of t-PA in the OSAHS group were significantly decreased as compared with the control group （ P 〈0.05 ）. There were significant differeence in the plasma level of p-selectin and t-PA between the preoperation and half year after the operation（ P 〈0.05）. The plasma level of P-selectin was correlated positively with AHI, and negatively with SaO2 min （ P 〈0.01 ）, while the activity of t-PA was correlated negatively with AHI, and positively with SaO2 min （ P 〈0.01 ）. Conclusions It is suggested the OSAHS may be associated with elevated plasma P-selectin level and decreased t-PA activity. The operation is of elect on correcting the changs in P-selectin and t-PA in the patient with OSAHS.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 血栓 手术 

分 类 号：R563.8[医药卫生—呼吸系统]