脑梗塞合并阻塞性睡眠呼吸暂停综合征患者血栓形成相关因素分析

The relative factors of rhrombosis in obstructive sleep apnea syndrome and cerebrovascular disease

目的探讨阻塞性睡眠呼吸暂停综合征(OSAS)患者合并脑血管疾病(CVD)的体内血栓形成相关因素及发病机制。方法对确诊的OSAS伴CVD患者、对照组(OSAS患者、CVD患者、非OSAS非CVD患者)各30例,监测多导睡眠图PSG和头颅CT检查;测定外周血清内皮素(ET)作为血管内皮功能指标;经颅多普勒超声(TCD)检测大脑中动脉的血流速度作为脑血流动力学指标;同期检测血液流变学指标。结果 OSAS伴CVD组患者的呼吸紊乱指数、最长呼吸暂停时间、血氧饱和度(SaO22)<0.9时间与其他三组相比均高,而最低血氧饱和度则显著低于其他三组,差异有统计学意义;该组患者的血浆内皮素、全血低切粘度、高切粘度、血小板聚集率及血浆纤维蛋白原均高于其他三组,差异有显著性;而凝血酶原时间、部分凝血活酶时间显著低于其他三组,差异有显著性。结论 OSAS与脑血管发病有密切相关,对OSAS患者进行诊断、治疗,对防治脑血管病有重要意义。

Objective To explore the relative factors between the obstructive sleep syndrome（OSAS） and cerebrovascular disease（CVD） and its mechanisms.Methods Thirty elderly patients were respectively selected as OSAS/CVDgroup、OSAS group、CVD group、nOSAS /n CVDgroup.Their blood samples were taken at 6：00 next morning immediately after overnight polysomnograpy（PSG） for testing vascular endothelial function and hemorheology.Head CT scan and transcranial doppler（TCD） were administered to all subjects when they were hospitalized.Results Apnea hypopnea index（AHI）、mean oxygen saturation level during sleep time（MSaO2）、the lowest oxygen saturation level（LSaO2） and the longest apnea time（LAT） in OSAS/CVD group were measured significantly higher than other groups;The levela of endothelin（ET）,The levela of WBV and plasma Fng in OSAS/CVD group were obviously higher than those in other control groups,while PT and APTT in OSAS/CVD group were shorter than those in control groups.Conclusion There were some relative factors between OSAS and cerebrovascular disease.OSAS can deteriorate cerebrovascular disease.It is necessary for early treatment and prevention of the disease.