持续正压通气治疗对中重度阻塞性睡眠呼吸暂停低通气综合征患者血清Pentraxin-3水平、baPWV的影响  

Effect of CPAP therapy on serum level of Pen-traxin-3 and baPWV in patients with moderate and severe OSAHS

作　　者：张波 蒋兆华[1] 徐云海[1] ZHANG Bo;JIANG Zhaohua;XU Yunhai(Punan Hospital of Shanghai Pudong District Shanghai 200125)

机构地区：[1]上海市浦东新区浦南医院,上海200125

出　　处：《陕西医学杂志》2019年第4期438-441,共4页Shaanxi Medical Journal

基　　金：上海市科技计划项目(2017SF106)

摘　　要：目的:探讨持续正压通气(CPAP)治疗对中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清正五聚蛋白-3(Pentraxin-3)水平、肱踝动脉脉搏波传导速度(baPWV)等的影响。方法:随机选取84例中重度OSAHS患者作为观察组研究对象,另选取30例同期来我院进行健康体检无睡眠打鼾史者作为对照组。所有对象均行多导睡眠监测(PSG),根据监测结果分为单纯打鼾组(n=22)、轻度OSAHS组(n=24)、中重度OSAHS组(n=38),其中中重度患者均给予CPAP治疗。记录四组受检对象的AHI、LSaO_2指标,测定Pentraxin-3浓度及baPWV,采用埃普沃思困倦量表(ESS)对所有对象的主观嗜睡程度进行评价,其中中重度OSAHS患者分别于CPAP治疗前、后对上述各指标及评分各测定一次。结果:中重度OSAHS组患者的AHI、pentraxin-3、baPWV及ESS评分均明显高于对照组、单纯打鼾组、轻度OSAHS组,LSaO_2指标均明显低于对照组、单纯打鼾组、轻度OSAHS组(均P<0.05);CPAP治疗后中重度OSAHS组各指标均明显优于治疗前(P<0.05)。中重度OSAHS患者CPAP治疗前后的Pentraxin-3浓度与AHI、baPWV、ESS评分均呈明显正相关(均P<0.05),而与LSaO_2呈明显负相关(均P<0.05)。结论:中重度OSAHS患者的血清pentraxin-3和baPWV水平均明显偏高,临床中对中重度OSAHS患者行CPAP治疗可明显改善其血清中Pentraxin-3浓度及baPWV水平。Objective: To investigate the effect of continuous positive pressure ventilation (CPAP) on serum Pentraxin-3 level and baPWV in patients with moderate and severe obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: 84 cases of moderate and severe OSAHS were selected as the observation group, in the same period, 30 cases of health check-free snoring history were selected as the control group. All subjects were given polysomnography (PSG), according to the monitoring results, they were divided into simple snoring group ( n =22), mild OSAHS group ( n =24), moderate and severe OSAHS group ( n =38), and moderate and severe patients were given CPAP treatment. The AHI and LSaO2 indexes of four groups were recorded, serum level of positive five polyprotein -3 (Pentraxin-3) and brachial artery pulse wave conduction velocity (baPWV) were measured. The subjective sleepiness of all objects were evaluated by the Epworth Sleepiness Scale (ESS), the Each index and score of the patients with moderate and severe OSAHS were measured once before and after the treatment of CPAP, respectively.Results:The scores of AHI, Pentraxin-3, baPWV and ESS in the patients with moderate and severe OSAHS were significantly higher than those in the control group, the snoring group and the mild OSAHS group,the LSaO2 indexes were significantly lower than those of the control group, the simple snoring group and the mild OSAHS group ( P all<0.05);The indexes of medium and severe OSAHS group after CPAP treatment were significantly better than those before treatment ( P <0.05). The Pentraxin-3 concentration in patients with moderate and severe OSAHS before and after CPAP treatment was positively correlated with AHI, baPWV and ESS scores ( P all<0.05), but negatively correlated with LSaO2 and CPAP treatment time ( P all<0.05). Conclusion:The levels of serum Pentraxin-3 and baPWV in patients with moderate and severe OSAHS are significantly higher, CPAP treatment in patients with moderate and severe OSAHS can obviously improve the serum level of Pen

关 键 词：中重度阻塞性睡眠呼吸暂停低通气综合征 持续正压通气 正五聚蛋白-3 肱踝动脉脉搏波传导速度 埃普沃思困倦量表 对比研究 

分 类 号：R442.8[医药卫生—诊断学]