阻塞性睡眠呼吸暂停低通气综合征伴冠心病:血清高半胱氨酸和C-反应蛋白水平及临床意义

目的 通过对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并冠心病患者血清高半胱氨酸(HCY)和C-反应蛋白(CRP)水平的检测分析,探讨HCY、CRP与OSAHS及OSAHS合并冠心病的相关性.方法 将研究对象分为正常对照组(30例)、OSAHS组(36例)、OSAHS合并冠心病组(25例),采用化学发光法检测血清H...

E valuation and clinical significance of serum C-reactive protein and homocysteine level in obstructive sleep apnea/hypopnea syndrome complicated with coronary heart disease patients

Objective To explore the relationship between homocysteine(HCY) and C-reactive protein(CRP) in obstructive sleep apnea/hypopnea syndrome(OSAHS) patients and OSAHS patients compli cated with coronary heart disease by detecting the scrum level of HCY and CRP on the mechanism of OSAHS complicated with coronary heart disease.Methods Ninety-one patients were divided into three groups,30 patients as control group,36 patients as OSAHS group,and 25 patients as OSAHS complicated with CHD group.Serum HCY level was detected through chemiluminescence.Serum CRP level was detected through radioimmunity.The serum level of HCY and CRP was compared among these groups.OSAHS patients were divided into mild OSAHS subgroup,moderate OSAHS subgroup and severe OSAHS subgroup.The morbidity rate of CHD and the serum level of HCY and CRP were compared among these subgroups.Meanwhile the parameters of polysomnogram such as activity apnea-hypopnea index(AHI) and blood oxygen saturation (SaO2) were compared between OSAHS group and OSAHS complicated with coronary heart disease group.Results ① There was significant difference among the serum level of HCY and CRP of control group,OSAHS group and OSAHS complicated with CHD group (FHCY=15.80,FCRP=19.21,P all＜0.01 ).The serum level of HCY and CRP of OSAHS complicated with CHD group was significantly higher than that of OSAHS group (tHCY=4.74,tCRP=5.14,P all ＜0.01).The serum level of HCY and CRP of OSAHS group was significantly higher than that of control group (tHCY=7.31,tCRP=8.17,P all ＜0.01).②) The morbidity rate of CHD of severe OSAHS subgroup was significantly higher than that of mild OSAHS subgroup and that of moderate OSAHS subgroup (x2=6.96,x2=4.18,P＜0.05 ).The serum level of HCY and CRP were correlated with the severity of OSASH (FHCY=16.38,FCRP=12.97,Pall＜0.01 ).③ There were significant difference between apnea hyponea index and SaO2 of OSAHS group and OSAHS complicated with CHD group (tAHI=5.46,percentage of SaO2 ＜90％ in total sleep time:t=1.88,P all＜0.01 ; percentage of disordered breathing event in the total sleep time:t=2.47,P＜0.05; lowest SaO2:t=4.68,average lowest SaO2:t=3.65,longest duration of disordered breathing events:t =4.73,P all＜0.01 ).Conclusion The serum level of HCY and CRP rose because of hypoxia in OSAHS patients,and might play an important role in the mechanism of OSAHS complicated with CHD.