阻塞性睡眠呼吸暂停低通气综合征与动脉硬化的相关性  

Correlation between obstructive sleep apnea and hypopnea syndrome and arterial stiffness

作　　者：陈莹[1] 王镇山[1] 薛欣[1] 

机构地区：[1]大连医科大学附属第二医院呼吸内科,辽宁大连116027

出　　处：《大连医科大学学报》2014年第1期68-72,83,共6页Journal of Dalian Medical University

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea and hypopnea syndrome,OSAHS)和动脉硬化的关系及纤溶酶原激活物抑制剂-1(plasminogen activator inhibitor-1,PAI-1)在其中的可能机制。方法根据多导睡眠图(polysomnography,PSG)监测结果分对照组(7例)及OSAHS组(29例),分别检测脉搏传导速度(pulse wave velocity,PWV)、踝臂指数(ankle-brachial index,ABI);酶联免疫吸附法测定血浆PAI-1水平。根据呼吸暂停指数(apnea and hypopnea index,AHI)分对照组(AHI<5次/h)(7例)、轻度OSAHS组(5次/h≤AHI<15次/h)(12例)、中-重度OSAHS组(AHI≥15次/h)(17例),对比3组间动脉硬化阳性率。结果 OSAHS组AHI、PWV、PAI-1均显著高于对照组(均P<0.05);对照组、轻度OSAHS组及中-重度OSAHS组动脉硬化阳性率分别为28.6%、58.3%、82.4%,差异有显著性意义(P=0.048,P<0.05)。(3)双侧ABI与AHI(左r=-0.534,P=0.003,右r=-0.456,P=0.013)均呈负相关。结论 OSAHS增加动脉硬化发生率和动脉硬化的程度,血浆PAI-1在OSAHS患者动脉硬化形成上可能有一定作用。Objective To analyze the correlation between obstructive sleep apnea and hypopnea syndrome （ OSAHS） and arterial stiffness, and explore the possible regulatory role of plasma activator inhibitor -1（PAI-1）.Methods Polysomnog-raphy （PSG） monitoring were applied to assign cases into control group and OSAHS group .Pulse wave velocity（PWV）, ankle-brachial index （ABI） and enzyme-linked immunosorbent assay of PAI -1 were also examined.Based on apnea and hypopnea index （AHI）, the subjects were divided into 3 groups, control group （AHI〈5）, mild group （5≤AHI〈15）, and moderate-severe group （AHI≥15）.Fisher exact test was performed to compare the rate of arterial stiffness a-mong the 3 groups.Results （1） Compared with the control group, AHI, PWV, PAI-1 were significantly higher（P〈0.05）.（2） Fisher exact test showed that the arterial stiffness positive rates of the control group （n=7）, mild OSAHS group （n=12） and moderate-severe OSAHS group （n=17） were 28.6%, 58.3%, and 82.4%, respectively.Signifi-cant differences were achieved among these 3 groups （P=0.048, P〈0.05）.（3） Left and right ABI were negatively cor-related with AHI （left r=-0.534, P=0.003;right r=-0.456, P=0.013）.Conclusion OSAHS increases the inci-dence and the degree of arterial stiffness .Plasma PAI-1 may have some effect on arterial stiffness in patients with OS-AHS.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 动脉硬化 纤溶酶原激活物抑制剂-1 

分 类 号：R766[医药卫生—耳鼻咽喉科]