阻塞性睡眠呼吸暂停低通气综合征与动脉硬化的相关性

Correlation between obstructive sleep apnea and hypopnea syndrome and arterial stiffness

关键词:  阻塞性睡眠呼吸暂停低通气综合征  动脉硬化  纤溶酶原激活物抑制剂-1

Key words:  [Key words]　obstructive sleep apnea and hypopnea syndrome  arterial stiffness  plasminogen activator inhibitor-1

摘要:

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。

Abstract:

[Abstract] 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 Polysomnography (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 among 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. Significant differences were achieved among these 3 groups (P=0.048, P<0.05). (3) Left and right ABI were negatively correlated with AHI (left r=-0.534, P=0.003; right r=-0.456, P=0.013). Conclusion　OSAHS increases the incidence and the degree of arterial stiffness. Plasma PAI-1 may have some effect on arterial stiffness in patients with OSAHS.