经鼻持续气道正压通气对阻塞性睡眠呼吸暂停低通气患者纤维蛋白原和D-二聚体的影响

Effect of nasal continuous positive airway pressure treatment on fibrinogen and D-dimer in obstructive sleep apnea-hypopnea syndrome patients

目的观察阻塞性睡眠呼吸暂停低通气(OSAHS)患者经鼻持续气道正压通气(n-CPAP)治疗1个月前后纤维蛋白原(Fbg)和D-二聚体的变化及探讨其临床意义。方法选择我院2010年至2012年收治的157例OSAHS患者,随机分为实验组(85例)和对照组(72例),实验组中睡眠呼吸暂停低通气指数(AHI)中度42例,15<AHI<30;重度43例,AHI≥30),经n-CPAP治疗;72例OSAHS患者作为对照组,其中中度38例,15<AHI<30;重度34例,AHI≥30,未给予n-CPAP治疗,两组疗程均为1个月,测定治疗前后Fbg及D-二聚体变化,并进行治疗前后及组间比较。结果实验组治疗1个月后Fbg及D-二聚体均比治疗前显著降低(P<0.01),而对照组这两项指标均无明显变化(P>0.05)。结论 n-CPAP可降低OSAHS患者Fbg及D-二聚体,可能其具有降低心脑血管并发症,改善生活质量的功能。

Objective To explore the level of fibrinogen （Fbg） and D-dimer in obstructive sleep apnea-hypopnea syndrome （OSAHS） patients before and after nasal continuous positive airway pressure （n-CPAP） treatment for one month, and to discuss their clinical significance. Methods 157 OSAHS patients enrolled and treated in our hospital from 2010 to 2012 were recruited,of which 85 （42 moderate cases with 15 〈 AHI 〈 30, 43 severe cases with AHI~〉30） were selected as the experiment group, while the other 72 （38 moderate cases with 15 〈 AHI 〈 30,43 severe cases with AHI〉~30） as the control group. The experiment group was exposed to one month of n-CPAP treatment, while no any therapy was applied to the control group. The level of Fbg and D-dimer before and after one month in both groups were measured and compared. Results There was significant decrease of both Fbg and D-dimer level in experiment group after n-CPAP treatment（P 〈 0.05 ）, while no obvious change of Fbg or D-dimer was observed in control group （P 〉 O. 05）. Conclusion n-CPAP could reduce the expression of both Fbg and D-dimer, thus maybe possess the potential of reducing cardiovascular complications and improving quality of life in OSAHS patients.