阻塞性睡眠呼吸暂停综合征患者血栓形成前状态分子与颈动脉内膜中层厚度的关系

Correlation between pre-thrombotic state and tunica intima-media thickness of carotid artery in patients 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(OSAHS)患者血栓形成前状态(PTS)分子标志物与颈动脉内膜中层厚度的关系。方法:选择OSAHS患者56例和健康体检者28例为对照组,采用酶联免疫吸附法测定血清血小板颗粒膜蛋白-140(GMP-140)、血管性血友病因子(v WF)和抗凝血酶(AT)水平,采用底物发光法测定组织型纤溶酶原激活剂(t-PA)和血浆纤溶酶原激活物抑制剂1(PAI-1)水平;使用彩色多普勒超声检测颈动脉内膜中层厚度(IMT)。结果:OSAHS组血清GMP-140、v WF、Fbg、PAI-1水平高于对照组,血清AT、t-PA水平低于对照组,颈动脉内膜中层厚度高于对照组(P均<0.05)。血清GMP-140、v WF、Fbg、PAI-1水平与IMT呈正相关(r=0.507,0.411,0.392和0.458,均P<0.05)。血清AT、t-PA水平与IMT呈负相关(r=-0.401,-0.367,均P<0.05)。OSAHS患者GMP-140、v WF、t-PA水平与IMT成线性回归关系。结论:OSAHS患者存在着明显的PTS,同时颈动脉内膜增厚明显,PTS是导致患者颈动脉内膜增厚的重要因素之一。

Objective： To explore the correlation between pre-thrombotic state（ PTS） and tunica intima-media thickness（ IMT） of carotid artery in patients with obstructive sleep apnea hypopnea syndrome（ OSAHS）. Methods： 56 patients with OSAHS（ OSAHS group） and 28 healthy voluntrers（ control group） were involved in the study. The levels of serum thrombocyte granular membrane protein（ GMP-140）,von willebran factor（ v WF）,antithrombin（ AT） were detected by enzymelinked immunosorbent assay. The IMT of carotid artery were evaluated by ultrasonic imaging and the tissue-type plasminogen（ t-PA） and plasminogen activator inhibitor-1（ PAI-1） were tested by substrate chemiluminescence method. Results： Compared to those of control group,the serum levels of GMP-140,v WF,Fbg,PAI-1 and IMT were significantly higher in patients with OSAHS（ P 0. 05）,the levels of AT and t-PA were significantly lower in OSAHS group（ P 0. 05）. The IMT of carotid artery were positively correlated with serum levels of GMP-140,v WF,Fbg and PAI-1（ r = 0. 507,0. 411,0. 392 and 0. 458,all P 0. 05）,which were negatively correlated with the AT and t-PA（ r =-0. 401,-0. 367,all P 0. 05）. The IMT of carotid artery were in multiple linear regression with serum levels of GMP-140,v WF and t-PA. Conclusions： PTS and IMT of carotid artery were exist in OSAHS patients. PTS is one of the important factors in OSAHS patients with IMT.