持续气道正压通气对阻塞性睡眠呼吸暂停低通气综合征患者血液流变学及炎性因子变化的研究

Effect of continuous positive airway pressure treatment on serum levels of hemorheology and flammatory factor in patients with obstructive sleep apnea hypopnea syndrome

目的:探讨持续气道正压通气(CPAP)对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血液流变学及炎性因子的影响。方法:选择武汉大学中南医院和潜江市中心医院耳鼻咽喉头颈外科收治的87例中重度OSAHS患者纳为治疗组,37例健康者纳为对照组。检测对照组和CPAP治疗前后治疗组血液流变学中的血细胞比容(HCT)、全血粘度、血小板聚集率(PAG)、内皮素(ET)以及炎性因子中的白细胞介素6(IL-6)、白细胞介素18(IL-18)、肿瘤坏死因子(TNF-α)的变化。结果:治疗组治疗前HCT、全血黏度(高切、中切和低切)、PAG、ET水平以及IL-6、IL-18、TNF-α水平均高于对照组,差异有统计学意义(P<0.01);治疗组经CPAP治疗后、全血黏度(高切、中切和低切)、PAG、ET水平以及IL-6、IL-18、TNF-α水平较治疗前均明显降低,差异有统计学意义(P<0.01)。结论:CPAP治疗能有效地改善OSAHS患者血液流变学,降低炎症反应,具有良好的治疗效果。

Objective： To investigate the effects of continuous positive airway pressure （CPAP） on serum levels of he morheology and flammatory factor in patients with obstructive sleep apnea hypopnea syndrome. Methods： A total of 87 patients with moderate and severe OSAHS were enrolled as treatment group, 37 healthy persons were enrolled as control group. The patients in treatment group were given CPAP treatment. Levels of hematocrit （HCT）, whole blood viscosity, platelet aggrega- tion （PAG）, endothelin （ET）, interleukin-6 （IL-6）, interleukin-18 （IL-18） and tumor necrosis factor （TNF-α） were detected and compared between control group and treatment group （before and after treatment）. Results： Before treatment, the HCT, whole blood viscosity, PAG, ET , IL-6, IL-18, TNF-α levels of the treatment group were were significantly higher than those in the control group （P〈0.01）. After CPAP treatment, whole blood viscosity （high-cut, cut and low-cut）, PAG, ET, IL-6, I1.-18, TNF-α levels were significantly decreased comparing with that before treatment （P〈0.01）. Conclusion： CPAP has reliable curative effects on OSAHS patients, it can improve HCT, whole blood viscosity, PAG, ET, IL-6, IL-18 and TNF-α levels.