阻塞性睡眠呼吸暂停患者血栓形成高危因素的观察

目的　观察阻塞性睡眠呼吸暂停综合征 (OSAS)患者体内血栓形成高危因素的状况。方法　随机选择 2 4例中或重度OSAS患者 (OSAS组 )以及 19例正常成人 (对照组 ) ,分别于晨起 6时及午后 4时检测红细胞压积、血小板聚集率 (PAG)、血液粘滞度 (WPV)、凝血酶原时间 (PT)、部分凝血活酶时间 (APTT)、血浆纤维蛋白原 (Fng)及内皮素。 结果　OSAS组 6 :0 0A .M .与 4 :0 0P .M .相比 ,Hct、WBV、血浆Fng及PAG均明显增高 (均P <0 .0 5 ) ,PT及APTT缩短 (均P <0 .0 5 )。而对照组各项指标在 6 :0 0A .M .与 4 :0 0P .M .无明显差异 (P >0 .0 5 )。组间比显示与对照组 6 :0 0A .M .时相比 ,OSAS组 6 :0 0A .M .的Hct、WBV、PAG、血浆Fng及内皮素水平均明显升高 (均P <0 .0 5 ) ,而PT及APTT明显缩短 (均P <0 .0 5 )。与对照组 4 :0 0P .M相比 ,OSAS组 4 :0 0P .M的Hct、PAG及内皮素水平亦明显升高 (均P <0 .0 5 ) ,PT及APTT显著延长 (均P <0 .0 5 )。结论　OSAS存在显著的血栓高危因素 ,且清晨较午后更为明显。

Observation on changes of risk factors of thrombosis in patients with obstructive sleep apnea syndrome

Objective:To observe the risk factors of thrombosis in patients with obstructive sleep apnea syndrome (OSAS). Methods:24 patients with moderate and severe OSAS (OSAS group) and 19 healthy adults (control group) were randomly selected. Their blood samples were withdrawn at 6:00 A.M. and 4:00 P.M. respectively for testing hemocrit, platelet aggregation (PAG), whole blood viscosity (WBV),prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen (Fng) and endothelin (ET). Results:There was a significantly higher hemocrit, WBV, Fng and ET as well as a significantly shortening of PT and APTT at 6:00 A.M. than that at 4:00 P.M.in OSAS group. However, there were no significant difference of all testing items between the blood samples withdrawn at 6:00 A.M. and 4:00 P.M. in control group. The hemocrit, WBV, PAG, plasma Fng and ET were significantly higher, and PT and APTT were obviously shorter at 6:00 A.M. in OSAS group than that at 6:00 A.M.in control group. A higher hemocrit, PAG, plasma Fng and ET , a longer PT and APTT were observed at 4:00 P.M.in OSAS group, compared with that at 4:00 P.M.in control group. Conclusions:In OSAS patients there were strikingly risk factors of thrombosis, which is more remarkable in the early morning than in the afternoon.