血清同型半胱氨酸水平在阻塞性睡眠呼吸暂停低通气综合征和冠心病患者中的变化及其作用

The Levels and Role of Homocysteine in Patients with Obstructive Sleep Apnea Hypopnea Syndrome and Coronary Heart Disease

目的:观察血清同型半胱氨酸(Hcy)水平在阻塞性睡眠呼吸暂停低通气综合征(OSHAS)及冠心病(CHD)患者中的变化和作用。方法:收集临床确诊CHD、OSAHS、CHD+OSAHS患者各30例,分别为CHD组、OSAHS组和CHD+OSAHS组。平行检测各组血清Hcy水平及睡眠呼吸监测指标:呼吸暂停低通气指数(AHI)、夜间最低血氧饱和度(SaO2)及平均SaO2,比较各组Hcy水平的差异以及Hcy水平与睡眠呼吸监测指标的相关性。并与30例体检健康者(健康对照组)对比分析。结果:(1)血清Hcy水平:三病例组明显高于健康对照组(P<0.01),CHD+OSAHS组明显高于CHD组和OSAHS组(P<0.01),CHD组与OSAHS组比较,差异无统计学意义(P>0.05)。(2)病例组血清Hcy水平与AHI呈正相关(r=0.64,P<0.01),与夜间平均SaO2和夜间最低SaO2均呈负相关(r分别为-0.64、-0.65,P<0.01)。结论:血清Hcy水平升高与OSAHS患者SaO2减低有关,可能有利于CHD的发生与发展。

Objective：To observe the levels and role of serum homocysteine（Hcy）in the patients with obstructive sleep ap-nea hypopnea syndrome（OSHAS）and coronary heart disease（CHD）.Method：The levels of oserum Hcy and indica-tors for monitoring sleep apnea which involves of apnea hyponea index,average blood saturation and minimum night-time blood saturation were measured in CHD group,OSAHS group,CHD ＋ OSAHS group and healthy group of 30 patients,respectively.And the comparison with the healthy control group.Then to correlate analysis for Hcy and indicators for monitoring sleep apnea.Results：（1 ）Three cases of serum Hcy levels were significantly higher than the healthy control group （P〈0.01）;The levels of serum Hcy in CHD ＋ OSAHS group were highest among the four groups （P〈0.01）;there is no statistically significant difference between CHD group and OSAHS group （P〉0.05）.（2）The levels of of serum homocysteine had positively correlation with apnea hyponea index（r=0.64,P〈0.01）,then had negatively correlation with average blood saturation and minimum nighttime blood saturation（r=-0.64 and -0.65,P〈0.01）.Conclusion：Elevated homocysteine levels may be associated with oxygen saturation continued to reduce in patients with obstructive sleep apnea hypopnea syndrome,thereby increasing the occurrence and development of coronary heart disease.