摘要
目的评价经鼻无创正压通气(nCPAP)对阻塞性睡眠呼吸暂停综合征(OSAS)血栓前状态(PTS)的治疗效果。方法收集北京世纪坛医院2003年9月至2005年9月确诊的OSAS患者30例及同期健康对照者30名,血样采取均在经过前一夜睡眠监测及睡眠监测并nCPAP治疗后(OSAS组)仰卧位时立即进行。结果OSAS组与健康对照组比较,OSAS患者血液中血小板α颗粒膜蛋白-140(GMP-140)升高;部分凝血活酶时间(APTT)、抗凝血酶Ⅲ复合物(AT-Ⅲ)以及血浆组织型纤溶酶原激活物(t-PA)降低,血浆组织型纤溶酶原抑制物(PAI)升高,与健康对照组比较各个指标在两组之间的差异均有统计学意义。nCPAP治疗后OSAS组呼吸紊乱指数由(63.21±23.23)/h降至(0.56±0.84)/h,夜间最低血氧饱和度由0.68±0.07上升至0.90±0.02,GMP-140和PAI分别降至(17.07±7.97)%、(95.83±5.91)%,AT-Ⅲ和t-PA分别升高至(95.20±6.67)%、(5.45±1.61)μg/L。结论OSAS患者存在PTS,nCPAP治疗可部分或全部逆转PTS,减少与OSAS相关的心脑血管栓塞性疾病的发生。
Objective To estimate the effects of nasal continuous positive airway pressure （nCPAP） therapy on patients with OSAS in prethrombotic state. Methods One group of 30 patients with OSAS who were diagnosed from Sep. 2003 to Sep. 2005, one healthy control group of 30 cases. Blood samples were taken from people in the supine position in the morning immediately after overnight polysomnography and nCPAP theraphy （only in OSAS group）. Results Compared with the normal controls, the level of the molecular marker GMP - 140 increased in the blood of patients with OSAS, the levels of APTT, AT- Ⅲ decreased, and the level of t- PA decreased as well. The level of PAI increased. Compared with the healthy controls, datum indicated statistical differences between the two groups. Datum of the patients with OSAS were improved after nCPAP therapy ： AHI decreased from 63.21 ± 23.23 to 0. 56 ± 0. 84 ; the nocturnal lowest of SaO2 increased from 0. 68 ± 0.07 to 0. 90 ± 0. 02 ; GMP - 140 and PAI decreased to （ 17.07 ± 7.97） % and （ 95.83 ± 5.91 ） % respectively; AT - Ⅲ and t - PA increased to （95.20 ± 6.67） % and （ 5.45 ± 1.61 ） μg respectively. Conclusion Prethrombotic state is present in patients with OSAS. nCPAP therapy can decrease OSAS -related thrombotic complications.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2006年第7期1015-1017,共3页
Chinese Journal of Practical Internal Medicine
