阻塞性睡眠呼吸暂停综合征与脑血管病相关性临床研究

Clinic research on the relativity between obstructive sleep apnea syndrome and cerebrovascular disease

目的分析阻塞性睡眠呼吸暂停综合征(OSAS)与脑血管病(CVD)发病关系,探讨其发病机制。方法对确诊的50例OSAS患者和50例健康体检者,行多导睡眠图(PSG)监测,并检测所有对象的血脂(甘油三酯TG、胆固醇CH)、超敏C反应蛋白(hsCRP)、同型半胱氨酸(Hcy)指标、血黏度及凝血功能、血浆纤维蛋白原、动态血压。结果OSAS组多导睡眠图监测参数中呼吸紊乱次数、呼吸紊乱指数、平均呼吸暂停时间、最长呼吸暂停时间、低氧频数、低氧指数、动脉血氧饱和度SaO2<90%时间与对照组相比明显增高,动脉血氧饱和度SaO2(%)及最低动脉血氧饱和度SaO2(%)较对照组明显降低。OSAS组血脂、超敏C反应蛋白、同型半胱氨酸、血浆纤维蛋白原、血黏度、血压均高于对照组,而OSAS患者凝血酶原时间(PT)、凝血活酶时间(APTT)均低于对照组。结论OSAS与脑血管病的发病有密切关系,是长期以来尚未引起足够重视的危险因素之一。对OSAS患者进行正确的诊断、治疗,对防治脑血管病有重要意义。

Objective To analyze the relationship between obstructive sleep apnea syndrome （OSAS） and cerebrovascular disease （CVD）, and investigate the potential etiopathogenesis of OSAS. Methods 50 cases of OSAS in the experimental group and 50 cases of health people in the control group were conducted the Polysomnogram monitor. The blood-lipid （Triglyceride, cholesterol）, high-sensitivity C-reactive protein （hs CRP）, homocysteine （Hey）, blood viscosity, coagulation function, plasma fibrinogen and ambulatory blood pressure were measured in all the objects of the two groups. Results Compared to the control group, the variable parameters of polysomnogram, such as the time of disordered breathing, the index of disordered breathing, the average time of apnea and the longest time of apnea, the frequency of low oxygen, the index of low oxygen and the time when SaO2 〈 90%, were obviously improved, and the SaO2 and the lowest SaO2 were obviously decreased in the OSAS group. The blood-- lipid, the high--sensitivity C--reactive protein, homocysteine, plasma＇fibrinogen, blood viscosity and blood pressure in the OSAS group were higher than those of the control group （P〈 0.05）, otherwise the level of PT （prothrombin time） and APTT （activated partial thromboplastin time） were lower than those of the control group （P 〈 0. 05）. Conclusions OSAS has close relationship with the occurrence of eerebrovascular disease, and it is one of the important risk factors that do not get more attention for a long time. Diagnose and treatment of OSAS has important meaning in the prevention of eerebrovaseular disease.