阻塞性睡眠呼吸暂停低通气综合征患者血管内皮细胞、纤溶系统及抗凝血功能变化

CHANGE OF VASCULAR ENDOTHELIAL CELL、FIBRINOLYSIS SYSTEM AND ANTICOAGULANT IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA-HYPOPNEA SYNDROME

目的 探讨阻塞性睡眠呼吸暂停低通气综合征 (OSAHS)患者血管内皮细胞、纤溶系统及抗凝血功能变化。方法 选择年龄、性别、体重指数 (BMI)无明显差异的OSAHS患者 63例和健康查体者 56例 ,用多导睡眠呼吸监测仪进行监测 ,以Clauss法测定纤维蛋白原 (Fg) ,以发色底物法测组织纤溶酶原激活物活性 (t-PA :A)、纤溶酶原激活物抑制物 - 1活性 (PAI- 1 :A) ,抗凝血酶 -Ⅲ活性(AT -ⅢA) ,以酶联免疫法测vonWillebrand因子 (vWF)、组织纤溶酶原激活物抗原 (t-PA :Ag)、纤溶酶原含量 (PLg:Ag)和纤溶酶原激活物抑制物 - 1含量 (PAI- 1 :Ag)。以免疫火箭电泳法测抗凝血酶 -Ⅲ抗原 (AT -ⅢAg)。 结果 OSAHS组与对照组比较vWF、Fg、PAI - 1 :A、PAI- 1 :Ag明显升高 (P分别 <0 .0 0 1 ,0 .0 5 ,0 .0 1 ,0 .0 5) ,AT -ⅢAg、AT -ⅢA、PLg :Ag、t -PA :Ag明显降低 (P分别<0 .0 1 ,0 .0 5 ,0 .0 5 ,0 .0 5)。结论 OSAHS患者血管内皮细胞受损 ,纤溶及抗凝血功能减弱。

Objective To explore the change of Vascular endothelial cell、fibrinolysis system and anticoagulant in patient with obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods Polysomnography was performed in 63 patients with OSAHS and in 56 normal controls without difference in age、sex and body mass index(BMI). Fibrinogen(Fg) was measured by Clauss assay.Tissue plasminogen activator activity(tPA:A)、plasminogen activator inhibitory-1 activity(PAI-1:A)、antithrombin-Ⅲ activity(AT-ⅢA) was measured by chromogenic substrate assay. Von Willebrand factor (vWF)、tissue plasminogen activator antigen(tPA:Ag)、plasminogen antigen(PLg:Ag)、plasminogen activator inhibitory-1 antigen(PAI-1:Ag) was measured by enzyme linked immunosorbent assay. Antithrombin-Ⅲ antigen(AT-ⅢAg) was measured by rocket electroimmuno-diffusion. Results vWF、Fg、PAI:1A、PAI:1Ag were significantly higher in patients with OSAHS than in normal controls(P<0.001,0.05,0.01,0.05). AT-ⅢAg、AT-ⅢA、PLg:Ag、tPA:Ag were significantly lower in patients with OSAHS than in normal controls(P<0.01,0.05,0.05,0.05). Conclusion Vascular endothelial cell is damaged,lower fibrinolysis and anticoagulant in patient with OSAHS.