持续气道正压通气对OSAHS患者血管内皮细胞及纤溶系统的影响

为探讨经鼻持续气道正压通气（nCPAP)治疗前后阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者血管内皮细胞及纤溶系统的变化及临床意义，选择年龄，性别，体重指数（BMI）无明显差异的OSAHS患者38例和健康者对照组32例，用多导睡眠呼吸监测仪进行监测，以凝固法测定纤维蛋白原（Fg），发色底物法测组织纤溶酶原激活物活性（tPA：A）、纤溶酶原激活物抑制物－1活性（PAI－1：A），酶联免疫法测vonWillebrand因子（vWF)、组织纤溶酶原激活物抗原（tPA:Ag）、纤溶酶原含量（PLg:Ag)和纤溶酶原激活物抑制物－1含量（PAI－1：Ag）。结果OSAHS组与对照组比较，vWF,Fg,tPA:Ag、PAI－1：A明显升高（P分别＜0．01，0．001，0．001，0．01），PLg:Ag、tPA:A、tPA:Ag、最低血氧饱和度（SaO2low)明显降低（P分别＜0．01，0．001，0．001，0．01).nCPAP治疗后与治疗前比较，vWF,Fg,PAI-1:Ag,PAI-1:A明显降低（P分别＜0．05，0．01，0．01，0．01），PLg:Ag,tPA:A,tPA:Ag，最低SaO2明显升高（P分别＜0．05，0．001，0．001，0．01）。提示OSAHS患者血管内皮细胞损伤，凝血功能增强，纤溶系统功能减弱;nCPAP治疗能部分纠正各指标的异常。

Influence of Ncoap on vascular endothelial cells and fibrinolysis system in patients with obstructive sleep apnea-hypopnea syndrome

To investigate the influnce of nasal continual positive airway pressure (nCPAP) on vascular endothelial cells and fibrinolysis system of patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and evaluate their clinical significance, polysomnography was performed in 38 patients with OSAHS and 32 normal controls without difference in age, sex and body mass index (BMI). Fibrinogen(Fg) was measured by freezing assay. Plasminogen activator inhibitory-1 activity (PAI-1:A) and tissue plasminogen activator activity(tPA:A) were measured by chromogentic substrate assay. Von Willebrand factor(vWF), tissue plasminogen activator antigen (tPA:Ag), plasminogen antigen (PLg:Ag) and plasminogen activator inhibitory-1 antigen (PAI-1:Ag) were measured by enzyme linked immunosorbent assay. Results showed that vWF, Fg, PAI-1:Ag and PAI-1:A were significantly higher in patients with OSAHS than in normal controls (P<0.01,0.001,0.001,0.01). PLg:Ag, tPA:A, tPA:Ag and SaO 2low were significantly lower in patients with OSAHS than in normal controls (P<0.01,0.001,0.001,0.01). vWF, Fg, PAI-1:Ag and PAI-1:A were significantly lower after nCPAP than before nCPAP (P<0.05,0.01,0.01,0.01). PLg:Ag,tPA:A,tPA:Ag and SaO 2Low were significantly higher after nCPAP than before nCPAP (P<0.05,0.001,0.001,0.01). These suggest vascular endothelial cells are hurt, coagulant increases and ability of fibrinolysis system decreases in patients with OSAHS, and nCPAP therapy can correct some of the abnormalities.