阻塞性睡眠呼吸暂停低通气综合征患者动脉粥样硬化无创检测指标分析

目的检测血流介导的血管扩张(FMD)、脉搏波传导速度(PWV)和颈动脉内膜中层厚度(CIMT),探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与动脉粥样硬化之间的关系。方法对76例OSAHS患者(OSAHS组)及76例年龄、性别、体重指数与之相匹配患者(对照组)进行FMD、PWV和CIMT检测,对两组间FMD、PWV和CIMT值进行比较,对OSAHS组睡眠呼吸暂停低通气指数(AHI)与FMD、PWV和CIMT之间关系进行相关性分析。结果OSAHS组PWV(1720±247)cm/s]、CIMT(1.10±0.34)mm]显著高于对照组(1469±172)cm/s、(0.80±0.18)mm],FMD(5.8±1.7)%]显著低于对照组(8.9±1.4)%,P均<0.01];比较两组中所有伴高血压者,OSAHS组PWV、CIMT(1850±244)cm/s、(1.24±0.35)mm]仍显著高于对照组(1655±161)cm/s、(0.99±0.18)mm,P=0.001、0.003],FMD(5.2±1.7)%]显著低于对照组(7.5±1.1)%,P<0.01];OSAHS组AHI值与PWV、CIMT值呈正相关(r=0.883、0.698,P均<0.01),与FMD值呈负相关(r=-0.711,P<0.01)。结论OSAHS患者存在更为明显的内皮功能障碍及动脉粥样硬化,且与OSAHS严重程度有关。

A study on non-invasive indexes of atherosclerosis in obstructive sleep apnea-hypopnea syndrome patients

OBJECTIVE: To investigate the relationship between obstructive sleep apnea-hypopnea syndrome (OSAHS) and atherosclerosis through determining flow-mediated dilation (FMD), pulse wave velocity (PWV) and carotid intima-media thickness (CIMT). METHODS: FMD, PWV and CIMT were measured in 76 OSAHS patients (68 men/8 women) and 76 control subjects matched for age, sex and body mass index. FMD, PWV and CIMT were compared between the two groups. In the OSAHS group, correlations were calculated between apnea-hypopnea index (AHI) and FMD, PWV and CIMT. RESULTS: Compared to the control group, the OSAHS group had significantly higher PWV (1,720 +/- 247) cm/s vs (1,469 +/- 172) cm/s, P < 0.01] and CIMT (1.10 +/- 0.34) mm vs (0.80 +/- 0.18) mm, P < 0.01], but significantly lower FMD (5.8 +/- 1.7)% vs (8.9 +/- 1.4)%, P < 0.01]. When patients with hypertension from the two groups were compared, PWV (1,850 +/- 244) cm/s vs (1,655 +/- 161) cm/s, P = 0.001] and CIMT (1.24 +/- 0.35) mm vs (0.99 +/- 0.18) mm, P = 0.003] were significantly higher, and FMD (5.2 +/- 1.7)% vs (7.5 +/- 1.1)%, P < 0.01] was significantly lower in the OSAHS group (n = 43) than in the control group (n = 21). In the OSAHS group, AHI was correlated positively with PWV and CIMT (r = 0.883, 0.698, all P < 0.01), but negatively with FMD (r = -0.711, P < 0.01). CONCLUSION: Vascular endothelial dysfunction and atherosclerosis are present in OSAHS patients, and related to the severity of OSAHS.