冠心病合并OSAHS患者血浆超敏C-反应蛋白和纤维蛋白原的变化

High sensitivity C-reactive protein and fibrinogen in patients with coronary heart disease combined with obstructive sleep apnea hypopnea syndrome

目的:探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)及其干预治疗在冠心病(coronary heart disease,CHD)发生、发展过程中的临床意义。方法:观察测定39例CHD合并中-重度OSAHS患者、14例CHD合并轻度OSAHS患者和30例单纯CHD患者2个月规律持续气道正压通气(continuous positive airway pressure,CPAP)治疗前后血浆超敏C-反应蛋白(high sensitivity C-reactive protein,hs-CRP)、纤维蛋白原(fibrinogen,Fbg)的水平。结果:中-重度OSAHS合并CHD组患者血浆hs-CRP、Fbg水平较其余两组明显升高,治疗后两项检测指标均有显著下降,轻度OSAHS合并CHD患者仅治疗前血浆hs-CRP水平较单纯CHD对照组有明显增高。结论:冠心病患者血中hs-CRP和Fbg水平随OSAHS病情加重而增高,有效的CPAP治疗可减轻冠心病合并OSAHS患者的炎症反应和高凝状态。

Objective：To investigate the clinical significance of obstructive sleep apnea hypopnea syndrome（OS- AHS） and its intervention in the occurrence and development process of coronary heart disease（CHD）. Method： Determine the plasma levels of high sensitivity C-reactive protein（hs-CRP） and fibrinogen（Fbg） before and after two months of regularly continuous positive airway pressure（CPAP） treatment in 39 CHD patients combined with moderate or severe OSAHS, 14 CHD patients combined with mild OSAHS and 30 CHD patients without OSAHS. Result：In patients with CHD combined with moderate or severe OSAHS, there was remarkable increases of plasma hs-CRP and Fbg levels, and decreases with statistically significance after intervention. In patients with CHD com- bined with mild OSAHS, there was a statistically significant increase of plasma hs-CRP levels than in patients without OSAHS before CPAP treatment. Conclusion：In CHD patients, the plasma levels of hs-CRP and Fbg in- crease with OSAHS deteriorating. Effective CPAP treatment can reduce the risk factors in patients with CHD combined with OSAHS.