持续气道正压通气对阻塞性睡眠呼吸暂停综合征患者血管内皮及纤溶系统的影响  

Effect of continuous positive airway pressure ventilation on vascular endothelium and fibrinolytic system in patients with obstructive sleep apnea syndrome

作　　者：徐彦飞 李一禄[1] 陈济明[1] 陶春艳 陈柯颖 王加顿 XU Yan-fei;LI Yi-lu;CHEN Ji-ming;TAO Chun-yan;CHEN Ke-ying;WANG Jia-dun(Department of Respiratory and Critical Care Medicine,Shenzhen Nanshan District People′s Hospital,Guangdong Province,Shenzhen518000,China)

机构地区：[1]深圳市南山区人民医院呼吸与危重症医学科,广东深圳518000

出　　处：《中国当代医药》2020年第7期39-41,44,共4页China Modern Medicine

摘　　要：目的观察持续气道正压通气(CPAP)治疗对阻塞性睡眠呼吸暂停综合征(OSAHS)患者血管内皮及纤溶系统影响。方法选取2017年5月~2019年5月我院收治的84例OSAHS患者,按随机原则分为CPAP组(42例)和对照组(42例)。对照组给予常规治疗,CPAP组在对照组的基础上给予每晚不少于6 h的CPAP治疗,持续2周,比较治疗后两组血管内皮相关因子及凝血纤溶系统:一氧化氮(NO)、血管内皮生长因子(VEGF)、内皮素-1(ET-1),血浆组织纤溶酶原激活剂(t-PA)、血浆纤维蛋白原(FIB)、D-二聚体(D-D),嗜睡评分(ESS)和睡眠呼吸暂停低通气指数(AHI)变化。结果CPAP组ESS和AHI低于对照组;内皮功能方面NO高于对照组,VEGF和ET-1低于对照组;凝血纤溶系统方面t-PA高于对照组,FIB和D-D低于对照组,差异均有统计学意义(P<0.05)。结论CPAP可改善患者夜间缺氧,而纠正由此而引起的血管内皮系统损害及凝血纤溶系统功能改变。Objective To observe the effect of continuous positive airway pressure(CPAP)on vascular endothelium and fibrinolytic system in patients with obstructive sleep apnea syndrome(OSAHS).Methods A total of 84 patients with OSAHS admitted to our hospital from May 2017 to May 2019 were selected and randomly divided into CPAP group(42 cases)and control group(42 cases)by method of computer random control.The control group was given routine treatment,and CPAP group was given CPAP ventilation at least 6 hours per night on the basis of the control group.The treatment lasted for 2 weeks.The vascular endothelial related factors and coagulation and fibrinolysis system of the two groups were compared after treatment,including nitric oxide(NO),vascular endothelial growth factor(VEGF),endothelin-1(ET-1),plasma tissue plasminogen activator(t-PA),plasma fibrinogen(FIB),D-dimer(D-D),and changes of sleep score(ESS)and sleep apnea hypopnea index(AHI)were compared.Results ESS and AHI in CPAP group were lower than those in control group,NO in endothelial function was higher than that in control group,and VEGF and ET-1 were lower than those in control group,t-PA in coagulation and fibrinolysis system was higher than those in control group,FIB and D-D were lower than those in control group,the differences were statistically significant(P<0.05).Conclusion CPAP can ameliorate nocturnal hypoxia,thus correcting the damage of vascular endothelial system and the change of coagulation and fibrinolysis system function.

关 键 词：持续气道正压通气 阻塞性睡眠呼吸暂停综合征 血管内皮系统 纤溶系统 

分 类 号：R563.8[医药卫生—呼吸系统]