阻塞性睡眠呼吸暂停诱发心血管疾病的非血流动力学的可能机制研究

The possible non hemodynamic mechanism of cardiovascular disease in patients with obstructive sleep apnea syndrome

目的探讨阻塞性睡眠呼吸暂停(OSA)诱发患者心血管疾病的非血流动力学的可能作用机制。方法收集2017年6月至2018年4月诊治的睡眠呼吸障碍(SDB)患者43例,多导睡眠监测(PSG)患者夜间睡眠情况,以患者睡眠呼吸暂停低通气指数(AHI)情况分为控制组(21例)和OSA组(22例),其中OSA组根据病情严重程度又分为轻度OSA组(11例)和中重度OSA组(11例)。抽取患者禁食8 h后的隔日晨血检测相关指标水平,分析各检测指标变项与疾病的相关性。结果OSA组的血清超氧化物歧化酶(SOD)水平较控制组低(P<0.05),超敏C-反应蛋白(hs-CRP)和晨血纤维蛋白原(FIB)水平较控制组高(P<0.05)。轻度OSA组和中重度OSA组的SOD水平明显低于控制组,晨血FIB水平明显高于控制组(P<0.05),中重度OSA组的hs-CRP水平明显高于控制组(P<0.05)。结论OSA具有能增加氧化应激、炎性反应和凝血异常的非血流动力学作用,进而推测与患者日后并发心血管疾病的可能性增加有关。

Objective To explore the possible non-hemodynamic mechanism of cardiovascular disease induced by obstructive sleep apnea(OSA).Methods A total of 43 patients with sleep disordered breathing(SDB)who were diagnosed and treated in our hospital from June 2017 to April 2018 were emrolled in the study.The nocturnal sleep state of patients was monitored by polysomnography(PSG).According to the sleep apnea hypopnea index(AHI),these patients were divided into control group(n=21)and OSA group(n=22),moreover,the OSA group was redivided into mild OSA group(n=11)and moderate and severe OSA group(n=11)according to the severity of the disease.The morning blood specimens of patients after fasting for 8 hours were collected to detect the levels of non-hemodynamic related indicators that might induce cardiovascular diseases,and the blood sugar and blood lipid indexes of patients were also measured.In addition the correlation between above indexes and disease was analyzed.Results The SOD level in OSA group were significantly lower than those in control group(P<0.05),and hsCRP and FIB levels in morning blood group were significantly higher than those in control group(P<0.05).The SOD levels in mild OSA group,moderate and severe OSA group were significantly lower than those in control group,and FIB levels in morning blood group were significantly higher than those in control group(P<0.05).Moreover the hsCRP levels in moderate and severe OSA group were significantly higher than those in the control group(P<0.05).Conclusion The OSA has the non-hemodynamic effects of increasing oxidative stress,inflammation reaction and coagulation abnormality,which may be related to the increased risk of cardiovascular disease in the future.