合并OSAS的高血压患者超敏C反应蛋白水平的Meta分析被引量：3

Level of high-sensitivity C-reactive protein in patients with hypertension complicating obstructive sleep apnea syndrome: a Meta-analysis

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摘要目的探讨合并阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome,OSAS）的高血压患者血清超敏C反应蛋白（high sensitive C-reactive protein,hs-CRP）的水平。方法计算机检索Pub Med、Cochrane Library、EMbase、中国生物医学文献数据库（CBM）、中国知网（CNKI）、万方、维普电子数据库,检索时间截止至2014年12月,纳入合并OSAS的高血压患者检测血清hs-CRP的病例对照研究。对符合纳入标准的文献进行质量评价、数据提取,采用Revman5.3.5进行Meta分析。结果最终纳入15篇文献,包括2739例受试者。Meta结果显示：合并OSAS的高血压患者的血清hs-CRP水平明显高于健康人群（SMD=1.08,95%CI：0.68~1.49,P〈0.01）,亦明显高于单纯OSAS患者（SMD=0.59,95%CI：0.31~0.68,P〈0.01）、单纯高血压患者（SMD=0.38,95%CI：0.24~0.52,P〈0.01）;轻、中、重度OSAS合并高血压患者的血清hs-CRP水平均高于对照组（P〈0.05）,且随着严重程度的增加hsCRP呈增高趋势。结论 OSAS加重了高血压患者的炎症反应,且OSAS严重程度可能与hs-CRP水平相关。 Objective To investigate the level of high-sensitivity C-reactive protein（hs-CRP） in patients with hypertension complicating obstructive sleep apnea syndrome（OSAS）. Methods The databases of Pub Med, Cochrane Library, EMbase, CBM, CNKI, Wan Fang Database and VIP Database were retrieved with computer until Dec. 2014 for collecting the case-control studies on hs-CRP detection in patients with hypertension complicating OSAS. All eligible studies were given quality review, data extract and Meta-analysis by using Revman5.3.5 software. Results There were totally 15 studies included involving 2739 cases. The results of Meta-analysis showed that the level of hs-CRP was significantly higher in patients with hypertension complicating OSAS than that in health people（SMD=1.08, 95%CI： 0.68~1.49, P〈0. 01）, and also significantly higher than that in patients with only OSAS（SMD=0.59, 95%CI： 0.31~0.68, P〈0. 01） and than that in patients with only hypertension（SMD=0.38, 95%CI： 0.24-0.52, P〈0. 01）. The level of hs-CRP was higher in patients with hypertension complicating mild, medium or serious OSAS than that in control group（P〈0.05）, and the level of hs-CRP showed an ascending trend as severity of OSAS increased. Conclusion OSAS can exacerbate inflammatory reactions in patients with hypertension, and the severity of OSAS may be related to level of hs-CRP.

作者赵莹科张京春刘玥邬春晓马林沁张惠吕长霞雷舒雁

机构地区中国中医科学院西苑医院心血管病中心中国中医科学院心血管病研究所

出处《中国循证心血管医学杂志》 2016年第2期144-149,共6页 Chinese Journal of Evidence-Based Cardiovascular Medicine

基金国家自然科学基金面上项目课题资助(81373825) 国家中医临床基地行业专项课题资助(JDZX2012108)

关键词高血压阻塞性睡眠呼吸暂停综合症超敏C反应蛋白 META分析 Hypertension Obstructive sleep apnea syndrome High-sensitivity C-reactive protein Meta-analysis

分类号 R544.1 [医药卫生—心血管疾病]

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1Lavie P,Ben-Yosef R,Ami-hai ER. Prevalence of sleep apnea syndrome among patients with essential hypertension[J]. American heart journal,1984,108(2):373-6.
2Mart i nez-Garc ~ a MA,Campos-Rodr i guez F,Catal 6 n-Serra P,et al. Cardiovascular mortality in obstructive sleep apnea in the elderly: role of long-term continuous positive airway pressure treatment: a prospective observational study[J]. Am J RespirCrit Care Med,2012, 186(9):909-16.
3Logan AG,Perlikowskl SM,Mente A,et al. High prevalence of unrecognized sleep apnoea in drug-resistant hypertension[J]. Journal of hypertension,2001,19 ( 12):2271-7.
4Chobanian AV,Bakris GL, Black HR,et aL The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report[J]. JAMA,2003, 289(19):2560-71.
5Yokoe T,Minoguchi K,Matsuo H,et al. Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure[J]. Circulation,2003,107(8):1129-34.
6Shamsuzzaman AS,Winnieki M,Lanfranehi P,et al. Elevated C-reactive protein in patients with obstructive sleep apnea[J]. Circul ation,2002,105 (21 ):2462-4.
7Kokturk O,Ciftei TU,Mollareeep E,et al. Elevated C-reactive protein levels and increased eardiovaseular risk in patients with obstructive sleep apnea syndrome[J]. International heart journal,2005,46(5): 801-9.
8Bernardo Rodr i guez-Iturbe,Nosratola D Vaziri. Mechanisms of disease: oxidative stress and inflammation in the pathogenesis of hypertension[J]. Nature Clinical Practice Nephrology, 2006,2(10):582-93.
9Meier-Ewert HK,Ridker PM,Rifai N,et al. Absence of diurnalvariation of C-reactive protein concentrations in healthy human subjects[J]. Clinical Chemistry,2001,47(3):426-30.
10Sesso HD,Buring JE,Rifai N,et al. C-reactive protein and the risk of developing hypertension [J]. JAMA,2003,290(22):2945-51.