无创正压通气对单纯OSA患者S100A12水平的影响

Effects of noninvasive positive pressure ventilation on S100A12 level in simple OSA patients

目的探讨无创正压通气(NPPV)对阻塞性睡眠呼吸暂停(OSA)患者血清钙结合蛋白S100A12水平及心血管疾病发生风险的影响。方法选择经多导联睡眠监测(PSG)确诊并经过全面检查排除心脑血管疾病、内分泌疾病、感染等疾病影响的单纯OSA患者78例(轻度37例,中重度41例)为OSA组,选择体检的健康志愿者46例为对照组,比较两组对象PSG指标及血清S100A12、超敏C反应蛋白(hs-CRP)水平;将41例中重度单纯OSA患者分为NPPV组(n=23)及常规治疗组(n=18),两组均进行OSA相关健康宣教、一般生活指导等,NPPV组同时加用NPPV治疗,治疗3个月后复查PSG指标及血清S100A12、hs-CRP水平。结果OSA组的Epworth嗜睡量表(ESS)评分、体质量指数(BMI)、呼吸暂停低通气指数(AHI)、hs-CRP、血清S100A12水平均高于对照组,最低血氧饱和度(L-SpO 2)低于对照组,两组比较差异均有统计学意义(P<0.05)。NPPV组治疗后与同组治疗前及常规治疗组治疗后比较,ESS评分、AHI、hs-CRP、S100A12水平较明显下降,L-SpO 2明显升高,差异均有统计学意义(P<0.05)。常规组治疗前后ESS评分、BMI、AHI、L-SpO 2、hs-CRP、S100A12水平比较,差异均无统计学意义(P>0.05)。结论对无并发症的单纯OSA患者,NPPV早期干预治疗可明显降低血清S100A12水平,并降低心血管疾病发生风险。

Objective To explore the effects of noninvasive positive pressure ventilation(NPPV)on serum Calcium-binding protein S100A12 level and cardiovascular disease risk in patients with obstructive sleep apnea(OSA).Methods 78 simple OSA patients excluding cardiovascular and cerebrovascular diseases,endocrine diseases,infections and other diseases diagnosed by polysomnography were recruited as the OSA group(37 cases of mild OSA and 41 cases of moderate and severe OSA),46 healthy subjects were recruited as the control group.PSG monitoring index and serum S100A12,hypersensitive C-reactive protein(hs-CRP)level of the two groups were compared.41 patients with moderate and severe simple OSA were divided into the NPPV group(n=23)and the conventional treatment group(n=18),Both group was conducted OSA related health education and general life guidance,etc,the NPPV group was treated with NPPV at the same time.Re-examination was conducted after 3 months of the treatment.Results The Epworth sleepiness score(ESS),body mass index(BMI),apnea hyponea index(AHI),hs-CRP,serum S100A12 levels in the OSA group were higher while the L-SpO2 is lower than those in the control group(P<0.05).After NPPV therapy,the ESS,AHI,hs-CRP and S100A12 levels of the NPPV group decreased comparing with before treatment in the NPPV group and after treatment in the conventional group,while L-SpO2 increased significantly(P<0.05).And there was no statistically significant difference in these factors before and after treatment in the conventional group(P>0.05).Conclusion For simple OSA patients without complications,early intervention of NPPV treatment can obviously reduce serum S100A12 level,reduce the risk of cardiovascular disease.