阻塞性睡眠呼吸暂停低通气综合征与动脉硬化的相关性

目的：探讨阻塞性睡眠呼吸暂停低通气综合征（ obstructive sleep apnea and hypopnea syndrome ，OSAHS）和动脉硬化的关系及纤溶酶原激活物抑制剂-1（plasminogen activator inhibitor -1， PAI-1）在其中的可能机制。方法根据多导睡眠图（polysomnography， PSG）监测结果分对照组（7例）及OSAHS组（29例），分别检测脉搏传导速度（ pulse wave velocity ，PWV）、踝臂指数（ ankle-brachial index ，ABI）；酶联免疫吸附法测定血浆PAI-1水平。根据呼吸暂停指数（apnea and hypopnea index ， AHI）分对照组（AHI＜5次/h）（7例）、轻度OSAHS组（5次/h≤AHI＜15次/h）（12例）、中-重度OSAHS组（AHI≥15次/h）（17例），对比3组间动脉硬化阳性率。结果 OSAHS组AHI、PWV、PAI-1均显著高于对照组（均P＜0．05）；对照组、轻度OSAHS组及中-重度OSAHS组动脉硬化阳性率分别为28．6％、58．3％、82．4％，差异有显著性意义（P＝0．048，P＜0．05）。（3）双侧ABI与AHI（左r＝-0．534， P＝0．003，右r＝-0．456，P＝0．013）均呈负相关。结论 OSAHS增加动脉硬化发生率和动脉硬化的程度，血浆PAI-1在OSAHS患者动脉硬化形成上可能有一定作用。

Correlation between obstructive sleep apnea and hypopnea syndrome and arterial stiffness

Objective To analyze the correlation between obstructive sleep apnea and hypopnea syndrome （ OSAHS） and arterial stiffness, and explore the possible regulatory role of plasma activator inhibitor -1（PAI-1）.Methods Polysomnog-raphy （PSG） monitoring were applied to assign cases into control group and OSAHS group .Pulse wave velocity（PWV）, ankle-brachial index （ABI） and enzyme-linked immunosorbent assay of PAI -1 were also examined.Based on apnea and hypopnea index （AHI）, the subjects were divided into 3 groups, control group （AHI〈5）, mild group （5≤AHI〈15）, and moderate-severe group （AHI≥15）.Fisher exact test was performed to compare the rate of arterial stiffness a-mong the 3 groups.Results （1） Compared with the control group, AHI, PWV, PAI-1 were significantly higher（P〈0.05）.（2） Fisher exact test showed that the arterial stiffness positive rates of the control group （n=7）, mild OSAHS group （n=12） and moderate-severe OSAHS group （n=17） were 28.6%, 58.3%, and 82.4%, respectively.Signifi-cant differences were achieved among these 3 groups （P=0.048, P〈0.05）.（3） Left and right ABI were negatively cor-related with AHI （left r=-0.534, P=0.003;right r=-0.456, P=0.013）.Conclusion OSAHS increases the inci-dence and the degree of arterial stiffness .Plasma PAI-1 may have some effect on arterial stiffness in patients with OS-AHS.