OSAS老年患者及合并冠心病患者血管内皮功能的变化

Analysis of the Correlation between Vascular Endothelial Dysfunction and Coronary Heart Disease in Elderly Patients with Obstructive Sleep Apnea Syndrome

【目的】分析阻塞性睡眠呼吸暂停综合征（OSAS）老年患者及合并冠心病（CHD）患者血管内皮功能的变化。【方法】选取2014年2月至2015年8月本院收治的OSAS患者32例（0SAS组），另选取同时期我院收治的0SAS合并冠心病患者35例（0SAS合并CHD组），对两组患者的睡眠呼吸暂停指数（AHI）和氧减饱和指数（ODI）进行监测分析，并测定对比两组患者血管内皮功能相关指标血浆内皮素（ET）、一氧化氮（NO）及ET／NO比值。【结果】与OSAS合并CHD组患者对比，0SAS组患者的ODI、AHI、最低SpO2及平均SpO2均显著降低，差异均具有统计学意义（均P〈0．05）；与0SAS合并CHD组对比，OSAS组患者的ET及NO／ET显著降低，NO水平显著升高，差异有统计学意义（均P〈0．05）。【结论】0SAS合并CHD老年患者存在明显的血管内皮功能障碍，对0SAS老年及合并CHD患者应关注血管内皮功能障碍的影响。

[Objective]To analyze the correlation between vascular endothelial dysfunction and coronary heart disease （CHD） in elderly patients with obstructive sleep apnea syndrome （OSAS）. [Methods]A total of 32 cases of patients with OSAS in our hospital from February 2014 to August 2015 were selected as the OSAS group. Another 35 cases of patients with CHD and OSAS in the same time period at our hospital were selected as the OSAS and CHD group. Apnea-hypopnea index （AHI） and oxygen desaturation index （ODI） of patients in both groups were detected. Meanwhile, plasma endothelin （ET）, nitric oxide （NO） and NO/ET ratio were compared between patients of the two groups, and the correlation between OSAS patients with vascular endothelial dysfunction and coronary heart disease were analyzed. [Results]Compared to OSAS and CHD group, ODI, AHI, the lowest SpO2, and mean SpOz were significantly decreased in the OSAS group; the difference had statistical significance （ P 〈0.05）. ET and NO/ET also decreased significantly in the OSAS group compared to the OSAS and CHD group. In contrast, NO levels significantly increase in the OSAS group compared to the OSAS and CHD group; the difference was statistically significant （ P 〈0.05）. [Conclusion]Obstructive sleep apnea syndrome complicated with coronary heart disease in elderly patients has obvious effect on endothelial dysfunction and vascular endothelial. Therefore, active prevention and treatment of vascular endothelial dysfunction can improve the prognosis of the patients with OSAS and CHD.