血浆同型半胱氨酸在诊断妊娠合并阻塞性睡眠呼吸暂停低通气综合征中的临床价值

Clinical value of total plasma homocysteine in diagnosing pregnancy combined with obstructive sleep apnea hypopnea syndrome

目的探讨妊娠合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与血浆同型半胱氨酸(Hcy)的相关性以及其可能的发病机制。方法选择妊娠合并OSAHS患者30例和正常妊娠组20例行多导睡眠呼吸监测系统监测记录呼吸暂停低通气指数(AHI);采用循环酶法测定血浆Hcy水平,同时测定平均动脉压(MAP)和24h尿蛋白。结果正常妊娠组与妊娠合并OSAHS组Hcy、AHI、MAP和24h尿蛋白比较有统计学差异(P均<0.01);AHI值与MAP、24h尿蛋白、Hcy呈正相关(r分别为:0.746、0.763、0.705,P均<0.01);Hcy值与MAP、24h尿蛋白呈正相关(r分别为:0.623、0.615,P均<0.01)。结论妊娠合并OSAHS患者病情与Hcy水平密切相关;妊娠合并OSAHS部分参与了妊娠期高血压疾病(HDCP)的病理过程,并有可能是HDCP中的一个重要的致病因素。

Objective To investigate the possible pathogenesis and the correlation between the total plasma homocysteine （Hcy） and patients with pregnancy combined with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods Thirty pregnancy women combined with OSAHS and twenty healthy pregnancy women were randomly selected to record all night polysomnography （PSG） , and record apnea hypopnea index（AHI）. We measured the plasma Hcy levels, mean arte- rial pressure（MAP） , and 24 h urine protein. Results The Hey, AHI, MAP and 24 h urine pro- tein in patients with pregnancy combined with OSAHS were significantly higher than those of the controls （all P 〈0.01 ）. The AHI was significantly correlated with MAP, 24 h urine protein, Hcy （ r = 0. 746, 0. 763, 0. 705, all P 〈 0.01 ）. On the other hand, Hcy values were positively correlated with MAP and 24 h urine protein （ r = 0. 623, 0. 615, all P 〈 0.01 ）. Conclusions The condition of patients with pregnancy combined with OSAHS is closely related with the level of Hcy. Pregnancy combined with OSAHS may be taken part in the pathology process of HDCP, and it is a possibly independent factor of high risk in HDCP.