阻塞性睡眠呼吸暂停低通气综合征对不稳定型心绞痛患者炎症补体水平的影响及其与冠状动脉狭与冠状动脉狭窄程度的相关性研究

The effect of OSA on the level of inflammatory complement in patients with unstable angina and its correlation with the degree of coronary artery stenosis

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSA)对不稳定型心绞痛患者炎症补体系统标记物水平的影响及其与冠状动脉狭窄程度的相关性。方法回顾性分析首都医科大学附属北京安贞医院2018年7月至2019年7月167例不稳定型心绞痛患者,所有患者均进行过睡眠呼吸监测,根据监测结果将AHI≥15的患者分为OSA组(63例),其余为对照组(104例),比较入院时既往病史、用药、实验室检查、血清CRP、C1q水平和冠状动脉病变Gensini评分等指标。结果OSA组Gensini评分[27.00(26.80,49.20)vs20.00(19.56,28.19),P=0.039]、CRP[1.63(1.43,7.34)vs 1.42(1.10,4.21)mg/L,P=0.001]、C1q[(187.95±29.73)vs(176.18±29.70)mg/L,P=0.028]显著高于对照组;AHI与Gensini评分具有正相关性(r=0.367,P<0.001);多因素回归分析发现AHI(P=0.001)、CRP(P=0.015)和C1q(P=0.006)均是影响冠状动脉狭窄程度的独立因素。结论OSA患者血清CRP和C1q水平显著升高,且OSA严重程度与冠心病患者冠状动脉狭窄程度具有相关性。

Objective To explore the effect of obstrucive sleep apnea(OSA)on the levels of inflammatory complement system markers in patients with unstable angina and its correlation with the degree of coronary artery stenosis.Methods A retrospective analysis of 167 patients with unstable angina and underwent polysomnography in Beijing Anzhen Hospital,Capital Medical University,from July 2018 to July 2019 was made.Patients with apnea and hypopnea index(AHI)≥15 were divided into OSA group(n=63)and other patients were divided into control group(n=104).The previous medical history,medication,laboratory examination,sleep breathing monitoring indicators,serum CRP,C1q and the Gensini score at admission were compared.Results Gensini score[27.00(26.80,49.20)vs 20.00(19.56,28.19),P=0.039],CRP[1.63(1.43,7.34)vs 1.42(1.10,4.21),P=0.001]and C1q[187.95±29.73 vs 176.18±29.70,P=0.028]of OSA group were significantly higher than those of control group.AHI was positively correlated with Gensini score(r=0.367,P<0.001).Multivariate regression analysis found that AHI(P=0.001),CRP(P=0.015)and C1q(P=0.006)were independent factors of coronary stenosis.Conclusion Serum CRP and C1q levels in OSA patients were significantly increased,and the severity of OSA was correlated with the degree of coronary stenosis in patients with coronary heart disease.