急性脑梗死合并阻塞性睡眠呼吸暂停综合征患者糖脂代谢特征、动脉粥样硬化特征评估

The characteristics of glycolipid metabolism as well as atherosclerosis in patients with obstructive sleep apnea-hypopnea syndrome combined with cerebral infarction

目的:评估急性脑梗死合并阻塞性睡眠呼吸暂停综合征(OSAHS)患者的糖脂代谢特征及动脉粥样硬化特征。方法:选择2015年3月~2018年2月期间因急性脑梗死在我院就诊的患者,并根据是否合并OSAHS将300例急性脑梗死患者分为合并OSAHS的脑梗死A组和不合并OSAHS的脑梗死B组;另取同期在我院体检的健康志愿者100例作为对照组。测定血清中糖脂代谢指标、细胞因子、斑块水解分子的含量。结果:脑梗死A组、脑梗死B组患者血清中胰岛素(F-Ins)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、钙黏素(VE-cadherin)、人软骨糖蛋白39(YKL-40)、FKN、巨噬细胞集落刺激因子(M-CSF)、单核细胞趋化蛋白1(MCP-1)、基质金属蛋白酶(MMP)9、Caspase-3、ICTP、血管细胞黏附分子-1(VCAM-1)的含量均显著高于对照组,高密度脂蛋白胆固醇(HDL-C)的含量均显著低于对照组;脑梗死A组血清中F-Ins、TC、LDL-C、VE-cadherin、YKL-40、FKN、M-CSF、MCP-1、MMP9、Caspase-3、ICTP、VCAM-1的含量均显著高于脑梗死B组,HDL-C的含量均显著低于脑梗死B组。差异均有统计学意义(P<0.05)。结论:脑梗死合并OSAHS患者存在更为显著的糖脂代谢紊乱且斑块稳定性较差。

Objective：To evaluate the characteristics of glycolipid metabolism as well as atherosclerosis in patients with obstructive sleep apnea-hypopnea syndrome（OSAHS）combined with cerebral infarction.Methods：Patients who were treated in the hospital due to acute cerebral infarction between March 2015 and February 2018 were selected,and according to the combination of OSAHS,the 300 patients with cerebral infarction were divided into the cerebral infarction group A who were combined with OSAHS and the cerebral infarction group B who were not combined with OSAHS;the 100 cases of healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group.The contents of glycolipid metabolism indexes,cytokines and plaque hydrolysis molecules in serum were determined.Results：Serum FIns,TC,LDL-C,VE-cadherin,YKL-40,FKN,M-CSF,MCP-1,MMP9,Caspase-3,ICTP and VCAM-1 levels of cerebral infarction group A and cerebral infarction group B were significantly higher than those of control group whereas HDL-C levels were significantly lower than those of control group（P0.05）;serum F-Ins,TC,LDL-C,VE-cadherin,YKL-40,FKN,MCSF,MCP-1,MMP9,Caspase-3,ICTP and VCAM-1 levels of cerebral infarction group A were significantly higher than those of cerebral infarction group B whereas HDL-C level was significantly lower than that of cerebral infarction group B（P〈0.05）.Conclusion：There are more significant glycolipid metabolism disorders and worse plaque stability in patients with OSAHS combined with cerebral cerebral infarction.