阻塞性睡眠呼吸暂停低通气综合征并冠心病患者血浆TM的测定

Measurement of plasma soluble thrombomodulin in obstructive sleep apnea-hypopnea syndrome patients with coronary heart disease

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)并冠状动脉粥样硬化性心脏病(简称冠心病)的血管内皮功能受损情况。方法选取2009-07～2013-02于我院就诊的184例患者,常规记录患者一般资料,行多导睡眠监测和冠状动脉造影。冠状动脉造影前采集空腹静脉血,采用酶联免疫吸附法(ELISA)测定血浆血栓调节蛋白(TM)。结果根据多导睡眠图和冠状动脉造影结果,184例患者分为对照组、冠心病组、OSAHS组及OSAHS并冠心病组。各组在年龄、性别构成及体重指数(BMI)方面差异无统计学意义(P均>0.05)。对照组、冠心病组、OSAHS组、OSAHS并冠心病组血清TM水平(OD值)分别为(2.91±1.81)、(20.45±35.57)、(21.93±44.32)、(42.13±59.82)(P均<0.05);对照组低于其他三组,OSAHS并冠心病组高于其他三组(P均<0.05),但冠心病组与OSAHS组差异无统计学意义。结论 OSAHS并冠心病患者存在更为广泛、更为严重的内皮功能受损,OSAHS是冠心病的危险因素之一。

Objective To Explore the endothelial function in obstructive sleep apnea hypopnea syndrome （OSAHS） patients with coronary atherosclerotic artery disease （CHD）. Methods One hundred and eighty-four sub- jects were recruited in our hospital from July 2009 to February 2013, recorded the gender, age, height, weight, etc, and all subjects attended sleep-laboratory polysomnography and coronary angiography. Fasting venous blood before cor- onary angiography was collected, and the level of plasma thrombomodulin （TM） was detected by the enzyme-linked immunosorbem assay （ELISA）. Results According to the results of polysomnography and coronary angiography, 184 patients were divided into control group, CHD group, OSAHS group, and OSAHS-CHD group. There were no signifi- cant difference among the four groups in age, sex, and body mass index （BMI）. In plasma TM level, the control group were lower than CHD group,OSAHS group,and OSAHS-CHD group （2.91 -＋ 1.81 VS 20.45 ＋ 35.57,2. 91 -＋ 1.81 ~5 21.93 ＋44. 32,2.91 ＋ 1.81 ~S 42. 13 ＋59. 82,P all 〈0.05） ; OSAHS-CHD group was significantly high- er than the control group, CHD group, OSAHS group（42. 13 -＋59.82 VS 2. 91 -＋ 1.81, 42. 13 -＋59. 82 VS 20.45 -＋ 35.57,42.13 ＋ 59.82 VS 21.93 -＋ 44. 32 ,P 〈 0. 05 ）, but no significant difference between CHD group and OSAHS group （20. 45 ＋ 35.57 VS 21.93 ＋ 44. 32, P 〉 0.05 ）. Conclusion Patients with OSAHS and CHD have a serious vascular endothelial function disorder, OSAHS is one of the risk factors for coronary heart disease.