阻塞性睡眠呼吸暂停低通气综合征患者C反应蛋白、纤维蛋白原和红细胞沉降率水平分析

Analysis of C-reactive protein, fibrinogen and erythrocyte sedimentation rate in patients with obstructive sleep apnea hypopnea syndrome

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者C反应蛋白(CRP)、纤维蛋白原(FIB)和红细胞沉降率(ESR)的变化及其与睡眠呼吸参数之间的关系。方法选择2015年6月至2018年8月在萍乡市人民医院经多导睡眠监测(PSG)确诊的OSAHS患者[睡眠呼吸低通气指数(AHI)≥5次/h]70例(观察组)及鼾症患者(AHI<5次/h)20例(对照组)为研究对象,检测并比较两组的CRP、FIB、ESR水平及其与睡眠呼吸参数的相关性。结果两组年龄、性别和体质量指数(BMI)差异均无统计学意义(均P>0.05)。观察组CRP、FIB、ESR分别为(4.5±3.0)mg/L、(3.3±0.9)g/L、(11.4±5.4)mm/h,均明显高于对照组的(2.0±1.5)mg/L、(2.9±0.5)g/L、(7.6±2.6)mm/h,差异均有统计学意义(t=5.12、2.68、4.36,均P<0.05)。CRP与AHI、氧减指数(ODI)均呈正相关(r=0.285、0.282,均P<0.05),与最低血氧饱和度(SaO2)、平均SaO2均呈负相关(r=-0.257、-0.259,均P<0.05);FIB与AHI、ODI均呈显著正相关(r=0.430、0.311,均P<0.01),与最低SaO2呈显著负相关(r=-0.287,P<0.01);ESR与睡眠呼吸参数均无相关性。结论OSAHS患者CRP、FIB、ESR均增高,且CRP、FIB与OSAHS严重程度有较好的相关性,提示OSAHS患者存在系统性炎性反应。

Objective To investigate the changes of C-reactive protein(CRP), fibrinogen(FIB) and erythrocyte sedimentation rate(ESR) in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS), and their relationship with sleep respiratory parameters. Methods From June 2015 to August 2018, 70 OSAHS patients[observation group, apnea hypopnea index(AHI)≥5/h]and 20 persons in the snoring control group(control group, AHI<5/h) who received the monitor of polysomnography in the Pingxiang People′s Hospital were enrolled.The levels of CRP, FIB and ESR were measured and compared between the two groups.The correlations were analyzed between the levels of inflammatory markers and sleep breathing parameters. Results The two groups had no statistically significant differences in age, gender and BMI(all P>0.05). The CRP, FIB and ESR of the observation group were (4.5±3.0)mg/L,(3.3±0.9)g/L,(11.4±5.4)mm/h, respectively, which were significantly higher than those of the control group[(2.0±1.5)mg/L,(2.9±0.5)g/L,(7.6±2.6)mm/h](t=5.12, 2.68, 4.36, all P<0.05). The level of CRP was positively correlated with AHI, oxygen desaturation index(ODI)(r=0.285, P<0.05 and r=0.282, P<0.05), and negatively correlated with the lowest SaO2 and the average SaO2(r=-0.257, P<0.05 and r=-0.259, P<0.05). The level of FIB was positively correlated with AHI, ODI(r=0.430, P<0.01 and r=0.311, P<0.01), and negatively correlated with the lowest SaO2(r=-0.287, P<0.01). There were no correlations between ESR and sleep breathing parameters. Conclusion The levels of CRP, FIB and ESR are increased in OSAHS patients, and the levels of CRP and FIB are proportional to the severity of OSAHS, suggesting that OSAHS patients has systemic inflammatory response.