阻塞性睡眠呼吸暂停低通气综合征患者血流变及血栓前标志物水平的研究

A study onhemorrheology and prethromboticstate markers levels in patients with obstructive sleep apnea hypopnea syndrome

目的:检测阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血流变及血栓前标志物水平的变化,探讨OSAHS患者并发心脑血管血栓栓塞性疾病的可能机制。方法:选取经多导睡眠监测仪监测诊断的86例OSAHS患者,分为轻度组、中度组、重度组。选取20例健康者为正常对照组。检测各组间血流变指标及血栓前标志物水平并进行相关分析。结果:轻、中及重度OSAHS组患者全血粘度、红细胞聚集指数、红细胞电泳时间均高于正常对照组。不同程度OSAHS组患者血流变指标差异有统计学意义,且全血粘度、红细胞聚集指数、红细胞电泳时间随OSAHS程度加重而升高。OSAHS患者血浆粘度与正常对照组比较差异无统计学意义。OSAHS患者血浆中D-D、AT-Ⅲ、v WF的水平与正常对照组比较差异无统计学意义。结论:OSAHS患者存在血粘度、红细胞聚集升高、红细胞电泳时间延长等血流变异常改变,可能是OSAHS患者心脑血管血栓栓塞性疾病发生率增加的原因之一。

Objective To detect the change of hemorrheology and prethromboticstate markers levels in patients with obstructive sleep apnea hypopnea syndrome（OSAHS） and to explore the pathogenic mechanisms of cardio-cerebrovascular thromboembolic diseases in OSAHS patients. Methods Polysomnography was performed in 86 patients with OSAHS and in 20 control subjects matched for age and body mass index. The patients with OSAHS were divided into mild group, moderate group, and severe group according to the apnea hypopnea index（AHI）. Hemorrheology and prethromboticstate markers levels were measured in all the subjects for correlation analysis. Results The whole blood viscosity, erythrocyte aggregation index, and erythrocyte electrophoresis time in mild OSAHS group, moderate OSAHS group and severe OSAHS group were significantly higher than those in the control group. The whole blood viscosity, erythrocyte aggregation index, and erythrocyte electrophoresis time were also significantly different between the three OSAHS groups, increasing with the severity of OSAHS. Plasma viscosity was not significant difference between OSAHS groups and the control group. Plasma D-D, AT-Ⅲ and v WF levels were also not significant difference between OSAHS groups and the control group. Conclusions The change of hemorrheology in OSAHS patients may contribute to the vulnerability of patients to cardiocerebrovascular thromboembolic diseases.