颈动脉内膜中层厚度与中青年阻塞性睡眠呼吸暂停低通气综合征关系

目的探讨颈动脉内膜中层厚度(IMT)与中青年阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的关系。方法测定39例中青年OSAHS(其中19例合并高血压)患者清晨7:00血压、呼吸暂停低通气指数(AHI)及颈动脉IMT值,并选择年龄、性别、体重指数相匹配的正常人作为对照。结果中、重度中青年OSAHS的颈动脉IMT值较正常人及轻度OSAHS显著增加(P<0.01),OSAHS合并高血压较单纯性OSAHS患者的颈动脉IMT显著增加(P<0.01)。结论中青年中、重度OSAHS已存在血管形态学改变,合并高血压以后,这一趋势将更明显。     

高血压合并阻塞性睡眠呼吸暂停低通气综合征患者与颈动脉粥样硬化的相关性研究

目的高血压合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与颈动脉粥样硬化的关系。方法入选就诊我院高血压患者145例,根据睡眠呼吸监测结果,分为高血压合并轻度OSAHS组、高血压合并中度OSAHS组和高血压合并重度OSAHS组,比较组间超敏C反应蛋白、白介素-6、颈动脉内膜中层厚度(IMT)。结果三组比较,超敏C反应蛋白、白介素-6、IMT差别有统计学意义,随着呼吸暂停低通气指数(AHI)严重程度增加,超敏C反应蛋白、白介素-6、IMT增加。结论高血压病合并OSAHS,颈动脉硬化、超敏C反应蛋白、白介素-6水平与睡眠呼吸暂停严重程度相关,超敏C反应蛋白、白介素-6可评估OSASH病情严重程度,在动脉硬化中发挥重要作用。     

老年阻塞性睡眠呼吸暂停低通气综合征与颈动脉粥样硬化的关系分析

目的探讨老年阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者与颈动脉粥样硬化之间的关系。方法对83例老年OSAHS患者(OSAHS组)及76例年龄、性别、体重指数与之相匹配老年人(对照组)行颈动脉超声检查,测定颈动脉内膜中层厚度(IMT)、阻力指数(RI)并进行比较。结果OSAHS组中IMT、RI显著高于对照组,差异有显著性意义(P<0.01)。两组伴高血压患者之间进行比较,也有显著差异。结论老年OSAHS患者已存在明显的颈动脉粥样硬化,如合并高血压,这一趋势更显著。     

阻塞性睡眠呼吸暂停低通气综合征患者血浆白细胞介素-18水平与动脉粥样硬化的关系

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血浆IL-18水平与动脉粥样硬化的关系.方法 选取就诊的男性OSAHS患者52例,年龄26～77岁,分为轻度组16例,中度组18例,重度组18例,另选对照组18例.对其中OSAHS组中20例中重度患者进行持续气道内正压(CPAP)治疗,并检测颈动脉内膜中膜厚度(IMT),测定血浆白细胞介素-18(IL-18)的水平.采用方差分析、配对t检验及Pearson相关分析进行统计学处理.结果 轻度、中度和重度OSAHS组的IL-18水平分别为(352±76)ng/L、(600±84)ng/L和(798±110)ng/L,均明显高于对照组的(250±76)ng/L,且OSAHS各组间均有明显差别.重度OSAHS组颈动脉IMT较对照组和轻度OSAHS组明显增厚.血浆IL-18水平与颈动脉IMT、呼吸暂停低通气指数(AHI)呈显著正相关(r值分别为0.486、0.865,P均＜0.001),与最低脉搏氧饱和度呈显著负相关(r=-0.664,P＜0.001).CPAP治疗后OSAHS患者血浆IL-18水平明显降低,颈动脉IMT未见明显改变.结论 OSAHS患者颈动脉IMT增厚,血浆IL-18水平升高,两者密切相关.血浆IL-18水平升高与OSAHS严重程度相关,OSAHS相关炎症反应可能与动脉粥样硬化的进程相关.CPAP治疗能够改善患者AHI和最低脉搏氧饱和度,降低血浆IL-18水平.     

阻塞性睡眠呼吸暂停低通气综合征及其合并高血压患者血清氧化低密度脂蛋白、总抗氧化能力水平的变化及临床意义

目的 探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)及OSAHS合并高血压患者血清氧化低密度脂蛋白(oxidized low density lipoprotein,OX-LDL)、总抗氧化能力(total-antoxidant capability,T-AOC)水平的变化.方法 选择OSAHS患者22例,OSAHS合并高血压患者24例;健康对照组24例,测定血清OX-LDL、T-AOC水平.并与睡眠呼吸监测指标进行相关分析.结果 与正常对照组比较,OSAHS组及OSAHS合并高血压组血清T-AOC活性均降低(P＜0.05),OX-LDL浓度均升高(P＜0.01).OSAHS及OSAHS合并高血压患者血清OX-LDL、T-AOC水平与反映睡眠呼吸暂停严重程度的指标有相关性(P＜0.01).结论 OSAHS患者存在OX-LDL、T-AOC水平的变化,且与其病情严重程度相关;氧化应激及氧化损伤在OSAHS合并高血压患者中更明显.     

阻塞性睡眠呼吸暂停低通气综合症与高血压关系的分析

目的 探索伴有高血压的阻塞性睡眠呼吸暂停低通气综合症(OSAHS)的睡眠呼吸障碍特点,并分析两者间的关系.方法 对已诊断为OSAHS的患者中90例高血压和65例非高血压者进行相关指标的分析.结果 高血压组睡眠呼吸暂停低通气指数(AHI)高于非高血压组,体重指数(BMI)是引起两组间AHI差异的显著因素(F=23.92,P＜0.01).在引入年龄和BMI、AHI作为协变量后,两组间夜间平均SaO2和最低SaO2比较差异无显著性(P＞0.05);AHI是引起夜间缺氧的显著因素(P＜0.05).在不同的睡眠期,高血压组的阻塞性呼吸暂停指数(OAI)均显著高于非高血压组;引入相关协变量后,仍然存在显著性差异(P＜0.05);而两组间的低通气指数(HI)比较差异无显著性.OSAHS患者中高血压的危险因素是AHI、年龄、BMI.结论 伴有OSAHS的高血压患者的睡眠呼吸障碍程度更重,夜间低氧血症与高血压无关,而与睡眠呼吸障碍的严重度有关.在不同的睡眠期,高血压组的阻塞性呼吸暂停程度更严重.年龄、肥胖和睡眠呼吸障碍的严重程度是OSAHS患者中高血压的危险因素.     

高血压并发阻塞性睡眠呼吸暂停低通气综合征老年患者血脂水平

目的研究老年高血压合并阻塞性睡眠呼吸暂停综合征的血脂水平。方法 2008年9月至2010年12月我院收治老年高血压患者210例,根据呼吸暂停低通气指数(AHI)监测分为单纯高血压对照组44例,高血压合并轻度OSAHS组60例和高血压合并中重度OSAHS组106例,监测各组血压,比较各组患者的血脂水平差异。结果相对于单纯高血压患者,并发阻塞性睡眠呼吸暂停低通气综合征的患者,呼吸暂停低通气指数(AHI)高,血浆总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)水平均增高,高密度脂蛋白胆固醇(HDL-C)水平降低,有统计学意义(P<0.05)。结论老年高血压病人合并有OSAHS者,血脂水平受到明显影响。早期诊断和进行相应治疗对于预防心脑血管并发症、改善患者预后具有重要意义。     

缺血性卒中患者阻塞性睡眠呼吸暂停与颈动脉硬化关系的研究

目的 研究缺血性卒中患者阻塞性睡眠呼吸暂停和颈动脉硬化的关系.方法 收集2007年1～8月上海交通大学新华医院神经内科43例缺血性卒中患者,根据颈动脉斑块及内膜中层厚度(IMT)超声检查结果,分为颈动脉硬化组和正常组,同时用多导睡眠监测仪(PSG)监测,记录睡眠呼吸紊乱指数(AHI)、平均氧分压(SaO2)、夜间最低SaO2、SaO2＜90%时间、氧减指数即氧减饱和4%以上的次数和已知动脉粥样硬化危险因素(高血压、体重指数、糖尿病、高脂血症、吸烟等).结果 颈动脉硬化组患者中阻塞性睡眠呼吸暂停低通气综合征(OSAHS)发生率明显高于非颈动脉硬化组(P=0.022),睡眠监测指标AHI、SaO2＜90%时问、氧减指数与颈动脉IMT呈正相关,夜间最低SaO2、平均SaO2与颈动脉IMT呈负相关.结论 OSAHS是缺血性脑卒中患者动脉粥样硬化的独立影响因素.     

nCPAP 对中重度阻塞性睡眠呼吸暂停低通气综合征患者心肌供血的影响

目的 观察中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与心肌供血的关系,探讨经鼻持续气道内正压通气(nCPAP)治疗对中重度OSAHS患者心肌供血的影响.方法 将明确诊断为中重度OSAHS患者中随机分为持续nCPAP治疗1年以上的长期治疗组(n=32 例),短期治疗组(n=30 例)及对照组(n=31 例).治疗前三组的临床基本特征差异无统计学意义(P＞0.05).分别对治疗后的三组患者进行24h动态心电图和睡眠呼吸监测,观察呼吸睡眠暂停-低通气事件、心肌缺血负荷,同时实时观察呼吸暂停-低通气事件和血氧饱和度下降与心肌缺血的关系.结果 对照组中13 例(41.94%)夜间出现心肌缺血发作,心肌缺血负荷为(59.12±7.18)mm·min / h.其与呼吸暂停- 低通气累计持续时间及累计次数呈正相关(r=0.816、0.749,P＜0.01).随着血氧饱和度下降幅度增加,心肌缺血发作次数也增多,差异有显著统计学意义(P＜0.01).长期治疗组患者经1年的nCPAP 治疗后夜间心肌缺血发生例数(6.25%、41.94%)及心肌缺血负荷[(1.32±0.78)mm·min / h、(59.12±17.18)mm·min / h],与对照组相比均明显减少,差异有显著统计学意义(P＜0.01),与短期治疗组比较差异无明显统计学意义(P＞0.05).在短期组中,仅3 例(10.00%)夜间出现心肌缺血发作,心肌缺血负荷为(2.42±1.43)mm·min / h,与对照组比较,心肌缺血程度减少,差异有显著统计学意义(P＜0.01).结论 夜间心肌缺血在中重度OSAHS患者中较多见,且与呼吸暂停- 低通气持续时间、发生次数及血氧饱和度下降幅度有关.无论长期还是短期的nCPAP 治疗都能明显减少中重度OSAHS 患者夜间心肌缺血的发生例数.     

OSAHS合并高血压患者血浆同型半胱氨酸与颈动脉厚度的相关性观察

目的观察阻塞型睡眠呼吸暂停低通气综合征(OSAHS)、原发性高血压(EH)及OSAHS合并EH患者血浆同型半胱氨酸(homocysteine,Hcy)与颈动脉内膜中层厚度(carotidartery intima media thickness,IMT)的相互关系。方法选择OSAHS合并EH患者组33例,OSAHS患者组35例及EH患者组43例,采用全自动生化仪测定其血浆Hcy水平,及超声检测颈动脉IMT。结果 OSAHS合并EH组的血浆Hcy水平和IMT厚度明显高于OSAHS组及EH组,差异有统IMT厚度之间有较好的相关性(r=0.66,P<0.01)。结论 OSAHS患者存在内皮功能损害,OSAHS合并EH者内皮功能     

血栓弹力图在OSAHS并发慢性心力衰竭患者中的应用价值

目的 通过血栓弹力图评估阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome,OSAHS）并发慢性心力衰竭（CHF）患者的血凝状态,探讨血栓弹力图在OSAHS并发CHF患者中的应用价值。 方法 选择确诊为OSAHS并发CHF患者60例,按照2015年我国《阻塞性睡眠呼吸暂停低通气综合征诊治指南（基层版）》诊断标准中的睡眠呼吸指数（AHI）,将OSAHS并发CHF患者分为轻度组（20例,AHI 5~15次/h）、中度组（20例,AHI 16~30次/h）和重度组（20例,AHI>30次/h）。另随机选取同一时段我院健康体检者20例作为正常对照组,所有入组患者均记录一般情况,包括年龄、身高、体质量、性别、高血压病、吸烟史、饮酒史、腰围、睡眠监测结果、血栓弹力图结果（R值、MA值）。 结果 ①随着OSAHS并发CHF患者体质量指数（body mass index,BMI）的升高,AHI相应增大,差异有统计学意义（P<0.05）。②OSAHS并发CHF患者各组与正常对照组比较,R值明显减小,差异有统计学意义（P<0.05）。OSAHS并发CHF患者各组间R值比较,差异有统计学意义（P<0.05）。③OSAHS并发CHF患者各组与正常对照组比较,MA值明显增大,差异有统计学意义（P<0.05,P<0.01）。OSAHS并发CHF患者各组间MA值比较,差异有统计学意义（P<0.05,P<0.01）。 结论 OSAHS并发CHF患者病情越重R值越小、MA值相应增大。     

柏林问卷在阻塞性睡眠呼吸暂停低通气综合征筛查中的应用价值

目的 评价柏林问卷对OSAHS的筛查价值.方法以疑诊为OSAHS的患者为研究对象,进行柏林问卷调查及多导睡眠(polysomnogram,PSG)监测.根据柏林问卷结果将患者分为OSAHS高危组和低危组,根据PSG监测结果将患者分为非OSAHS组及轻、中、重度OSAHS组.比较各组患者的性别、年龄、体重指数、呼吸暂停低通气指数(apnea hypopnea index,AHI)及柏林问卷结果的差异.对柏林问卷结果与患者的年龄、呼吸暂停低通气指数、最低经皮血氧饱和度(the lowest SpO2,LSpO2)、微觉醒指数的关系进行相关性分析.将柏林问卷结果和PSG监测结果以四格表计算其敏感度、特异度、假阴性率、假阳性率、阳性似然比、阴性似然比及符合率等,判断其结果的真实性和可靠性.结果 共纳入OSAHS患者302例,其中男226例(74.8%),女76例(25.2%),年龄21～82岁,平均(50±14)岁,平均体重指数(28±5)kg/m2.柏林问卷危险度分级比较,非OSAHS组与轻度、中度及重度OSAHS组间差异有统计学意义(χ2=13.961,8.466,42.156,均P<0.0083);重度OSAHS组与轻度、中度OSAHS组间差异有统计学意义(χ2=9.439,11.162,均P<0.0083);轻度与中度OSAHS组间差异无统计学意义(P＞0.0083).病情较重者中,柏林问卷提示OSAHS高危与PSG诊断符合率较高(χ2=34.211,P<0.001).柏林问卷结果分级与患者的性别无相关性(P＞0.0083),与年龄、AHI及微觉醒指数正相关(r=0.125,0.346,0.198,均P<0.05),与LSpO2负相关(r=-0.371,P<0.01).柏林问卷筛查OSAHS的敏感度为71%,特异度为72%.结论 柏林问卷对OSAHS的筛查诊断具有一定的意义,柏林问卷评分与病情严重程度呈正相关,柏林问卷诊断重度OSAHS的敏感度较高.

Abstract：

Objective To investigate the value of Berlin questionnaire in screening obstructive sleep apnea hypopnea syndrome(OSAHS) among Chinese. Methods A total of 302 cases with suspected OSAHS were referred to our sleep laboratory. The Berlin questionnaire scores and polysomnography(PSG) monitoring data were analyzed. According to the Berlin questionnaire score, the patients were divided into high and lower risk groups for OSAHS . In terms of the PSG monitoring results, the patients were classified into non-OSAHS, mild, moderate and severe OSAHS groups. The age, gender, apnea hypopnea index(AHI), body mass index, and the Berlin questionnaire(BQ) result were compared among the 4 groups. The correlation of Berlin questionnaire result with age, AHI, the lowest SpO2 (LSpO2) and microarousal index(MAI) were analyzed.Results There were significant differences in the Berlin questionnaire results among non-OSAHS and the other 3 groups(χ2=13.961, 8.466, 42.156,P＜0.0083); and between the severe OSAHS and the other 2 groups(χ2=9.439,11.162,P＜0.0083). There was no statistical difference between the mild and moderate groups(P＞0.0083). The ratio of the high BQ risk patients had an increasing tendency as the severity of OSAHS was increased (χ2=34.211,P<0.01). The Berlin questionnaire results showed a positive correlation with age, AHI or MAI(r=0.125, 0.346,0.198,all P<0.05, respectively) but a negative correlation with LSpO2(r=-0.371, P<0.01). The Berlin questionnaire results showed no correlation with gender (P>0.05). The sensitivity and the specificity of the Berlin questionnaire in predicting sleep apnea were 0.71 and 0.72, respectively.Conclusions With the moderate sensitivity and the specificity, the Berlin questionnaire has some value in screening patients with OSAHS. However, it is not correlated with the severity of OSAHS in Chinese patients. Thus Berlin questionnaire has limited value in the screening of OSAHS among Chinese.     

Serum adiponectin levels in adult male patients with obstructive sleep apnea hypopnea syndrome

BACKGROUND: Adiponectin has been found to be associated with the pathogenesis of diabetes, obesity and some cardiovascular diseases, which usually coexist with obstructive sleep apnea hypopnea syndrome (OSAHS). However, an association between adiponectin and OSAHS has rarely been reported. OBJECTIVES: To investigate the levels of serum adiponectin in adult male patients with OSAHS. METHODS: Following polysomnographic examination, 86 adult male habitual snorers were divided into simple snorers (control group) and OSAHS patients (OSAHS group) who were further divided into mild, moderate and severe OSAHS subgroups based on their apnea hypopnea index (AHI). There was no significant difference in age, body mass index (BMI), fasting blood glucose (FBG) and insulin resistance expressed as homeostasis model assessment (HOMA) between the two groups. The serum adiponectin levels were measured by radioimmunoassay. RESULTS: Serum adiponectin levels were significantly lower in the OSAHS group than in the control (p < 0.01). Such a decrease in adiponectin level was most significant in patients with moderate and severe OSAHS. Pearson correlation analysis showed that in OSAHS patients, serum adiponectin level was negatively correlated with BMI, waist (WC) and neck (NC) circumferences, AHI and HOMA, but positively correlated with nadir pulse oxyhemoglobin saturation (nadir SpO2). After controlling for HOMA, BMI, NC and WC in OSAHS patients, a partial correlation analysis showed that adiponectin levels were negatively correlated with AHI but positively correlated with nadir SpO2. Multiple logistic regression analysis indicated that adiponectin was independently associated with OSAHS. CONCLUSIONS: Serum adiponectin levels were significantly lower in OSAHS patients than in simple snorers. OSAHS may cause a decrease in serum adiponectin level.     

气道正压通气对阻塞性睡眠呼吸暂停低通气综合征合并高血压患者脉压的影响

目的探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）合并高血压患者脉压的变化及经鼻持续气道正压通气（nCPAP）的影响。方法选择85例经多导睡眠图仪（PSG）诊断的OSAHS患者，同时随机选取15例中重度OSAHS患者进行nCPAP治疗，在PSG监测前后及期间每2小时测量其血压，计算出脉压、脉压变化幅度、平均收缩压及平均舒张压，并计算体重指数。结果41％OSAHS患者同时合并有高血压；OSAHS合并高血压组患者的呼吸紊乱指数、脉压及体重指数明显高于单纯OSAHS患者，其最低血氧饱和度以及平均血氧饱和度均低于单纯OSAHS患者；重度OSAHS患者的脉压、体重指数、平均收缩压及平均舒张压均明显大于轻、中度OSAHS患者，而轻、中OSAHS患者之间差异无显著性意义。nCPAP可提高OSAHS患者最低血氧饱和度，同时降低其呼吸紊乱指数、平均收缩压、平均舒张压及脉压。相关分析结果表明，呼吸紊乱指数与脉压（r=0．395，P〈0．01）、平均收缩压（r=0．403，P〈0．01）、平均舒张压（r=0．313，P〈0．01）呈正相关，与最低氧饱和度（r=-0．424，P〈0．01）呈负相关，与体重指数、平均氧饱和度无相关。结论脉压是OSAHS的严重程度及是否并发高血压心血管事件的预测因子；nCPAP能下调OSAHS患者脉压及血压，是缓解OSAHS病情进展的有效治疗措施。     

颈动脉粥样硬化及斑块的性质、部位与缺血性卒中的关系:回顾性病例对照研究

目的 探讨颈动脉内膜-中膜厚度(intime-media thickness,IMT)、颈动脉粥样斑块性质、部位以及颈动脉狭窄程度与缺血性卒中的关系.方法 回顾性收集行彩色多普勒超声检查的首发急性缺血性卒中患者(缺血性卒中组)和同期门诊和住院的非缺血性卒中患者(对照组),对两组人口统计学资料、血管危险因素和颈动脉粥样硬...     

阻塞性睡眠呼吸暂停低通气综合征对高血压Ⅰ级患者进驻高原后血压的影响

目的研究阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)对于短期进驻高原地区驻训的高血压Ⅰ级青年官兵血压的影响,并分析其机制。方法试验组测定9名高血压Ⅰ级并发OSAHS青年官兵的基础血压和高原驻训期间(10,30和60 d)血压、心率,并采集相应时间点外周血氧饱和度(SO2)、睡眠时间、睡眠呼吸暂停低通气指数(apnea-hypopnea index,AHI)、神经内分泌激素[肾素-血管紧张-醛固酮系统(RAAS)、皮质醇];对照组测定4名高血压Ⅰ级无OSAHS青年官兵的基础血压和高原驻训期间(10,30和60 d)血压、心率,并采集相应时间点SO2、睡眠时间、AHI、神经内分泌激素(RAAS、皮质醇)。结果试验组官兵进驻高原后收缩压和舒张压均较基线水平显著升高(P0.05),以舒张压升高为主。SO2下降显著(P0.05),睡眠时间显著缩短(P0.05),AHI显著增加(P0.05),神经内分泌激素水平(RAAS及皮质醇)显著升高(P0.05)。对照组官兵进驻高原前后血压、外周血SO2、睡眠时间、AHI及神经内分泌激素均无显著差异。结论高原地区可导致高血压Ⅰ级的青年患者短时间血压持续升高,其机制可能与OSAHS引起血SO2下降、睡眠时间缩短、AHI增加及神经内分泌系统激活相关。     

缺血性脑血管病患者阻塞性睡眠呼吸暂停低通气综合征与有症状颈动脉狭窄的关系

目的 探讨缺血性脑血管病(ischemic cerebrovascular disease,ICVD)患者阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)与颈动脉狭窄的关系,为制定颈动脉狭窄的干预策略提供参考.方法 从南京卒中注册系统中筛选出87例ICVD患者,根据呼吸暂停低通气指数(apnea-hypopnea index,AHI)将患者分为无OSAHS组(n=21)以及轻度(n=24)、中度(n=27)和重度(n=11)OSAHS组;另外,根据数字减影血管造影(digital subtraction angiography,DSA)结果,将患者分为无颈动脉狭窄组(n=34)和颈动脉狭窄组(n=49).分析脑血管病危险因素和OSAHS对ICVD患者颈动脉狭窄的影响.结果 无OSAHS以及轻度、中度和重度OSAHS组之间饮酒(χ2=8.56,P=0.036)、高血压(χ2=13.2,P=0.004)和颈动脉狭窄(χ2=22.97,P=0.006)患者比例均存在显著差异.单因素分析显示,年龄(OR=1.066,95% CI 1.023～1.112;P=0.003)、高血压(OR=3.587,95%CI 1.294～9.949;P=0.014)、饮酒(OR=5.275,95%CI 1.855～15.001,P=0.002)和OSAHS(OR=1.073,95%CI 1.033～1.115,P=0.000)是颈动脉狭窄的危险因素;多变量logistic回归分析显示,年龄(OR=1.113,95%CI 1.047～1.182;P=0.001)、OSAHS(OR=1.096,95%CI 1.034～1.160;P=0.000)、饮酒(OR=4.292,95% CI 1.217～15.139;P=0.024)是颈动脉狭窄的独立危险因素.Spearman等级相关分析提示,AHI水平与颈动脉狭窄程度呈正相关(r=0.435,P=0.000).无颈动脉病变组(n=34)、单侧病变组(n=22)和双侧病变组(n=27)AHI存在显著差异[(12.97±10.04)次/h对(21.40±16.38)次/h对(29.33±13.81)次/h,F=11.64,P<0.01].结论 OSAHS是颈动脉狭窄的独立危险因素,且与颈动脉狭窄严重程度呈正相关.AHI在一定程度上能反映颈动脉狭窄程度和颈部血管受累范围.     

The differences of carotid atherosclerosis among non-OSAHS and OSAHS patients of different severities: a cross-sectional study

Background

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a widely prevalent problem with many complications, such as hypertension and cerebral vascular diseases. Atherosclerosis, whose most severe outcome is ischemic stroke, is reported being affected by OSAHS. The objective of this article is to investigate the differences of carotid atherosclerosis patients with or without OSAHS by a cross-sectional research.

Materials and methods

Patients diagnosed with carotid atherosclerosis by ultrasonography were recruited. They were requested to fill the primary screening OSAHS questionnaire. Patients with high tendency of OSAHS underwent polysomnography (PSG) tests into OSAHS group, and patients without OSAHS were into non-OSAHS group. Blood tests and medical history were collected. Carotid atherosclerosis severity was analyzed by carotid artery intima-media thickness (IMT), carotid plaque, blood flow velocity, etc. Differences between the two groups and subgroups were analyzed.

Results

A total of 242 carotid atherosclerosis patients were enrolled including 118 non-OSAHS patients (38 males and 80 females) and 124 OSAHS patients (40 mild, 32 moderate, and 52 severe). Significant differences were found in PSV-ICA and EDV-ICA on both sides (p?<?0.05) but no significant differences on IMT and velocity of CCV. CA patients with OSAHS were younger than ones without OSAHS. With the severity of OSAHS increasing, the age of CA patients decreased. The more severity of OSAHS, the younger the patients were. There were no significant differences in comparing cholesterol, triglyceride, HDL, LDL, and glucose.

Conclusion

As far as CIMT, carotid plaque, blood flow velocity, and blood lipid are concerned, the severity of CA is not affected by the severity of OSAHS accordantly. The relationship between OSAHS and CA may not be dose dependent.

Trial registration

This study has been registered on clinical trials (No. NCT03665818).