阻塞性睡眠呼吸暂停低通气综合征合并冠心病患者纤维蛋白原及同型半胱氨酸水平分析

Analysis of Fibrinogen and Homocysteine Levels in Patients with Obstructive Sleep Apnea Hypopnea Syndrome Complicated with Coronary Heart Disease

目的:分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并冠心病(CHD)患者与纤维蛋白原(Fib)和同型半胱氨酸(Hcy)的关系。方法:选取2015年6月-2018年10月本院行多导睡眠图监测(PSG)确诊OSAHS患者90例,其中单纯OSAHS者50例为OSAHS组、OSAHS合并CHD者40例为OSAHS+CHD组,另选取本院经PSG检查正常者21例为对照组。检测并比较各组Hcy、Fib、睡眠呼吸参数(AHI、ODI、夜间最低SaO2、夜间平均SaO2),分析OSAHS患者Hcy、Fib水平与睡眠呼吸参数的相关性。结果:OSAHS+CHD组、OSAHS组Fib、Hcy、AHI、ODI水平均高于对照组,夜间最低SaO2、夜间平均SaO2均低于对照组,且OSAHS+CHD组Fib、Hcy水平均高于OSAHS组,差异均有统计学意义(P<0.05),但OSAHS+CHD组和OSAHS组各项睡眠呼吸参数比较,差异均无统计学意义(P>0.05);相关性显示,Fib水平与AHI呈正相关(P<0.05),与ODI、平均SaO2、最低SaO2均无相关性(P>0.05);Hcy水平与AHI、ODI均呈正相关(P<0.01),与平均SaO2呈负相关(P<0.05),与最低SaO2无相关性(P>0.05)。结论:Fib、Hcy水平与OSAHS合并CHD有着密切关系,OSAHS患者夜间反复间断缺氧导致体内出现氧化应激,引起Fib及Hcy水平升高,促进OSAHS患者CHD的发生和发展。

Objective:To analyze the relationship between obstructive sleep apnea hypopnea syndrome(OSAHS)complicated with coronary heart disease(CHD)and fibrinogen(Fib)and homocysteine(Hcy).Method:A total of 90 patients with OSAHS diagnosed by polysomnography(PSG)from June 2015 to October 2018 were selected,among them,50 patients with OSAHS alone were OSAHS group and 40 patients with OSAHS complicated with CHD were OSAHS+CHD group.Another 21 patients with normal PSG examination in our hospital were selected as the control group.The Hcy,Fib,sleep breathing parameters(AHI,ODI,minimum SaO2 at night and average SaO2 at night)were measured and compared in each group.The correlation between Hcy and Fib levels and sleep breathing parameters in OSAHS patients was analyzed.Result:The levels of Fib,Hcy,AHI and ODI in OSAHS+CHD group and OSAHS group were higher than those of control group,the minimum SaO2 and average SaO2 at night were lower than those of control group,Fib and Hcy levels in OSAHS+CHD group were higher than those of OSAHS group,the differences were statistically significant(P<0.05),but the sleep breathing parameters of OSAHS+CHD group and OSAHS group were compared,the differences were not statistically significant(P>0.05).The correlation showed that Fib level was positively correlated with AHI(P<0.05),but not with ODI,average SaO2 and minimum SaO2(P>0.05),Hcy level was positively correlated with AHI and ODI(P<0.01),negatively correlated with average SaO2(P<0.05),and not with minimum SaO2(P>0.05).Conclusion:Fib and Hcy levels are closely related to OSAHS combined with CHD,repeated intermittent hypoxia at night in OSAHS patients leads to oxidative stress in vivo,which leads to increased levels of Fib and Hcy,and promotes the occurrence and development of CHD in OSAHS patients.