摘要
目的探讨阻塞性睡眠呼吸暂停(OSAS)对冠状动脉粥样硬化斑块的影响。方法126例老年冠心病(CAD)患者根据多导睡眠仪监测结果,分为OSAS合并CAD组(62例)、无OSAS组(64例)。所有患者常规清晨空腹卧位取静脉血测定测定胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血常规白细胞计数、中性粒细胞分类及血清(hs—CRP)水平。根据冠状动脉造影术、64层螺旋CT检查结果记录OSAS合并CAD组、无OSAS组冠状动脉病变、Gensini评分及粥样硬化斑块情况。结果CAD合并OSAS组TC、TG、LDL-C分别为(5.76±0.85)mmol/L、(3.37±0.97)mmol/L、(3.65±0.58)mmol/L,HDL-C为(1.06±0.20)mmol/L,无OSAS组TC、TG、LDL-C分别为(4.26±0.78)mmol/L、(1.72±0.54)mmol/L、(2.91±0.58)mmol/L,HDL—C为(1.13±0.14)mmot/L,CAD合并OSAS组TC、TG、LDL-C均高于无OSAS组(t值分别为2.959、3.556、2.165,P〈0.05),HDL-C低于无OSAS组(t=2.545,P〈0.05);OSAS合并CAD组患者血白细胞数、中性粒细胞百分比及hs—CRP水平较无OSAS组明显增高(P〈0.05);OSAS合并CAD组冠状动脉多支病变发生率为51%,Gensini积分为(23.6±20.7)分,冠状动脉软斑块为(67.6±9.7)个,无OSAS组分别为30%,(18.9±19.4)分。(39.3±9.4)个,两组比较差异有统计学意义(t值分别为5.39,2.048,19.001,P〈0.05)。结论OSAS和冠状动脉粥样硬化性心脏病密切相关,促进冠状动脉粥样硬化斑块的形成。
Objective To investigate the effect of obstructive sleep apnea syndrome (OSAS) on coronary atheroselerosis plaque. Methods A total of 126 old patients with coronary artery disease (CAD) were selected and classified into two groups according to their results of polysomnography and coronary angiography: OSAS plus CAD group (n=62); no OSAS group (n=64). Peripheral venous blood samples were taken, and the levels of total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL-C), low density lipoprotein (LDL-C), white blood cell counts, neutrophil percent and high sensitive C reactive protein (hs-CRP) were measured. The cases with coronary lesion, Gensini scores and atherosclerosis plaque were recorded according to coronary arteriography and 64- slice spiral coronary CT angiography. Results The levels of TC, TG and LDL-C were higher in OSAS plus CAD group than in no OSAS group 〈(5.76±0.85) mmol/L vs. (4.26±0.78) mmol/L, (3.37±1.97) mmol/Lvs. (1.72±0.54) mmol/L, (3.65±0.58) mmol/Lvs. (2.91±0.58) mmol/ L, t= 2. 959, 3. 556, 2. 165, all P〈0. 051. The levels of HDL were lower in OSAS plus CAD group than in no OSASgroup ((0. 86±0. 20) mmol/L vs. (1.13±0.14) mmol/L, t=2.545, P〈0.051. The white blood cell counts, neutrophil percent and serum hs- CRP levels were higher in OSAS plus CAD group than in no OSAS group (all P〈0.05). In OSAS plus CAD group, the prevalence of muhivessel disease was 51%, Gensini scores were (23.6 ± 20.7) and coronary atherosclerosis plaques were (67.6±9.7) ,while the prevalence of multivessel disease was 30%, Gensini scores were (18.9± 19.4) and coronary atherosclerosis plaques were (39.3 ± 9.4) in no OSAS group. There were significant differences in the three parameters between the two groups ( z or t=5.39, 2. 048, 19. 001, all P〈0.05). Conclusions OSAS is associated with coronary artery disease and can accelerate the formation of coronary atherosclerosis plaque.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2010年第5期386-389,共4页
Chinese Journal of Geriatrics