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目的探讨阻塞性睡眠呼吸暂停综合征(OSAS)患者血炎症因子与动脉粥样硬化的关系。方法选取就诊的OSAS患者60例,分为轻度组20例,中度组20例,重度组20例,另选对照组20例。对其中OSAS组中40例中重度患者进行持续气道正压通气(CPAP)治疗,并检测治疗前后颈动脉内中膜厚度(IMT)、肱—踝脉搏波传导速度(ba PWV)以及血炎症因子(IL-18、TNF-α、hs-CRP、ICAM-1、VCAM-1、E选择素和P选择素)水平的差异作统计学处理。结果 OSAS组的血炎症因子水平明显高于对照组,且OSAS各组间均有明显差异(均P<0.05)。血炎症因子水平与颈动脉IMT、呼吸暂停低通气指数(AHI)、ba PWV呈正相关(P<0.01),与最低脉搏氧饱和度(Sp O2)呈负相关(P<0.01)。CPAP治疗后OSAS患者血炎症因子水平、IMT以及ba PWV均有下降。结论 OSAS患者颈动脉IMT增厚、ba PWV增快与血炎症因子水平增高显著相关。血炎症因子水平升高与OSAS严重程度相关,动脉粥样硬化的进展可能与OSAS相关的炎症反应有关。CPAP治疗能够改善患者AHI以及Sp O2,降低血炎症因子水平。
Objective To investigate the relationship between inflammatory factors and atherosclerosis in patients with obstructive sleep apnea syndrome (OSAS). Methods Sixty patients with OSAS were selected and divided into mild group (n = 20), moderate group (n = 20), severe group (n = 20) and alternative control group (n = 20). 40 cases of moderate and severe OSAS patients were treated with continuous positive airway pressure (CPAP) and carotid intima - media thickness (IMT), brachial - ankle pulse wave velocity (BA PWV) and blood inflammation before and after treatment Differences in the levels of IL-18, TNF-α, hs-CRP, ICAM-1, VCAM-1, E-selectin and P-selectin were statistically processed. Results The levels of inflammatory cytokines in OSAS group were significantly higher than those in control group, and there was significant difference between OSAS groups (all P <0.05). The levels of inflammatory cytokines were positively correlated with carotid IMT, AHI and ba PWV (P <0.01), but negatively correlated with Sp O2 (P <0.01). The levels of inflammatory cytokines, IMT and ba PWV in OSAS patients decreased after CPAP treatment. Conclusions The IMT of carotid artery in patients with OSAS is thickened, and the increase of ba PWV is associated with the increase of blood inflammatory factor. Elevated serum levels of inflammatory cytokines correlate with the severity of OSAS and the progression of atherosclerosis may be related to OSAS-related inflammatory responses. CPAP treatment can improve patients AHI and Sp O2, reduce the level of blood inflammatory cytokines.