COPD与OSAHS重叠综合征患者炎症、内皮功能及高凝状态分析  

Analysis of the inflammation,endothelial function and hypercoagulability in the patients with COPD and OSAHS overlap syndrome

作　　者：刘方方 LIU Fangfang(The First Affiliated Hospital of Henan University,Kaifeng 475000,China)

机构地区：[1]河南大学第一附属医院,开封475000

出　　处：《华夏医学》2025年第2期128-133,共6页Acta Medicinae Sinica

基　　金：2022年度开封市科技发展计划项目(2203024)。

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的重叠综合征患者的炎症反应、内皮功能及高凝状态变化。方法选取我院确诊的重叠综合征患者90例作为重叠组,另外选取90例不合并OSAHS患者的COPD患者作为COPD组,对比两组血清炎症因子、内皮功能指标、凝血功能指标。结果重叠组的PCT、IL-6、hs-CRP、NLR、ET-1、D-D、Fib水平显著高于COPD组患者,重叠组的血清NO水平低于COPD组,差异有统计学意义(P<0.05);重叠组的PT、APTT、TT时间短于COPD组患者,重叠组的FEV1/FVC、FEV1pred低于COPD组(P<0.05);GOLD>2级重叠综合征患者的PCT、IL-6、hs-CRP、NLR、ET-1、D-D、Fib水平显著高于GOLD≤2级重叠综合征患者,血清NO、FEV1/FVC、FEV1 pred低于GOLD≤2级重叠综合征患者(P<0.05);GOLD>2级重叠综合征患者的PT时间短于GOLD≤2级重叠综合征患者(P<0.05)。结论COPD与OSAHS重叠综合征患者的炎症反应程度、内皮功能受损较不合并OSAHS的COPD患者更为严重,并且与重叠综合征患者COPD病情程度有一定的关系。Objective To investigate the changes of the inflammation,endothelial function and hypercoagulability in the patients with chronic obstructive pulmonary disease(COPD)complicated with obstructive sleep apnea hypopnea syndrome(OSAHS)overlap syndrome.Methods 90 patients with overlap syndrome diagnosed in our hospital were selected as the overlap group,and another 90 COPD patients without OSAHS were selected as the COPD group.Serum inflammatory factors,endothelial function indexes and coagulation function indexes between the two groups were compared.Results The levels of PCT,IL-6,hs-CRP,NLR,ET-1,D-D and Fib in the overlapping group were significantly higher than those in the COPD group,and the serum NO level in the overlapping group was lower than that in the COPD group,showing a statistically significant difference(P<0.05).The PT,APTT and TT time in the overlapping group were shorter than those in the COPD group,and the FEV1/FVC and FEV1 pred in the overlapping group were lower than those in the COPD group(P<0.05).The levels of PCT,IL-6,hs-CRP,NLR,ET-1,D-D and Fib in the patients with GOLD>2 grade overlap syndrome were significantly higher than those in the patients with GOLD≤2 grade overlap syndrome,and the serum NO,FEV1/FVC and FEV1pred were lower than those in the patients with GOLD≤2 grade overlap syndrome(P<0.05).The PT time of patients with GOLD>2 grade overlap syndrome was shorter than that in the patients with GOLD≤2 grade overlap syndrome(P<0.05).Conclusion The degree of inflammation and endothelial function impairment in the patients with overlap syndrome is more serious than that in the COPD patients without OSAHS,and there is a certain relationship between the degree of COPD in the patients with overlap syndrome.

关 键 词：慢性阻塞性肺疾病 阻塞性睡眠呼吸暂停低通气综合征 重叠综合征 炎症反应 内皮功能 高凝状态 

分 类 号：R563[医药卫生—呼吸系统]