正常血压OSAS患者血清胎球蛋白A、颈动脉硬化指数和动脉内膜中层厚度的相关性分析

Relationship between serum fetuin A,carotid atherosclerosis index and carotid intima-media thickness in normotensive patients with obstructive sleep apnea syndrome

目的探讨血压正常阻塞性睡眠呼吸暂停综合征(OSAS)患者血清胎球蛋白A、颈动脉硬化指数及动脉内膜中层厚度的关系。方法选取血压正常OSAS患者64例作为病例组,健康体检人员30例作为对照组。检测并比较两组患者血清胎球蛋白A、颈动脉硬化指数(CSI)及动脉内膜中层厚度(cIMT)的差异。睡眠监测仪检测患者睡眠呼吸暂停低通气指数(AHI),分析病例组患者AHI与颈动脉硬化指数及动脉内膜中层厚度的相关性,分析胎球蛋白A与颈动脉硬化指数及动脉内膜中层厚度的相关性。结果病例组患者颈动脉硬化指数及动脉内膜中层厚度显著高于对照组,而血清胎球蛋白A显著低于对照组(P<0.05)。病例组AHI评分显著高于对照组;病例组最低血氧饱和度仅为(68.42±11.65)%,显著低于对照组的(92.55±4.64)%(P<0.05)。经Pearson相关分析,病例组患者AHI与cIMT及CSI之间均存在正相关(r=0.421,r=0.502;P<0.05),胎球蛋白A与cIMT及CSI之间均存在负相关(r=-0.515,r=-0.404;P<0.05)。结论低血清胎球蛋白A水平与正常血压OSAS患者亚临床颈动脉硬化显著相关。

Objective To explore the relationship between serum fetuin A, carotid atherosclerosis index （CSI） and carotid intima-media thickness（clMT） in normotensive patients with obstructive sleep apnea syndrome. Methods 64 cases of OSAS patients with normal blood pressure were selected as experimental group while 30 healthy people as con trol. Differences of serum fetuin A, carotid atherosclerosis index and carotid intima-media thickness between the two groups were measured and compared. Apnea hypopnea index （AHI） was determined with sleep monitor. The relation ship between AHI and CSI/clMT and correlation of fetuin-A with CSI/cIMT were analyzed. Results The carotid ath erosclerosis index and carotid intima-media thickness in experimental group were significantly higher than the control group, but serum fetuin-A was significantly lower （ P 〈 0.05 ）. Meanwhile, AHI of the experimental group was also significantly higher than the control （P 〈0.05 ）, while the lowest oxygen saturation was significantly lower （68.42 ± 11.65% vs. 92.55 ±4.64%, P 〈 0.05）. In the experimental group, Pearson correlation analysis showed AHI was positively correlated with cIMT and CSI （ r = 0. 421, r = 0. 502 ; P 〈 0.05 ） when fetuin-A was negatively correlated with clMT and CSI （ r = - 0. 515, r = - 0. 404 ; P 〈 0.05 ）. Conclusion Reduction of serum fetuin-A is associated with subclinical carotid atherosclerosis in the patients with normotensive OSAS.