中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
22期
39-42
,共4页
曹梅%陈飞鹏%邬勇坚%陈晓军
曹梅%陳飛鵬%鄔勇堅%陳曉軍
조매%진비붕%오용견%진효군
睡眠呼吸暂停%阻塞性%芳基二烷基磷酸酶%心血管疾病%血脂异常%连续气道正压通气
睡眠呼吸暫停%阻塞性%芳基二烷基燐痠酶%心血管疾病%血脂異常%連續氣道正壓通氣
수면호흡잠정%조새성%방기이완기린산매%심혈관질병%혈지이상%련속기도정압통기
Sleep apnea%obstructive%Aryldialkylphosphatase%Cardiovascular diseases%Dyslipidemias%Continuous positive airway pressure
目的 研究阻塞型睡眠呼吸暂停低通气综合征(OSAHS)患者血清对氧磷酶1(PON1)活性和血脂的关系,及经鼻持续气道正压通气(nCPAP)治疗前后的变化,探讨PONI在OSAHS并发心血管疾病中的可能作用.方法 86例OSAHS患者根据睡眠呼吸暂停指数(AHI)分为3组:轻度组(5＜AHI≤20) 24例,中度组(20＜ AHI≤40) 25例,重度组(AHI＞40) 37例.检测各组间血脂水平及PON1活性并与20例健康者(对照组)进行比较,相关参数进行相关性分析,其中21例中、重度OSAHS患者进行nCPAP治疗3个月后复查多导睡眠图(PSG)、PON1活性和血脂.结果 轻度组、中度组、重度组血清PON1活性分别为(143.56±29.47)、(121.50±25.76)、(103.11±24.54) kU/L,均低于对照组的( 164.35±33.89) kU/L,差异有统计学意义(P＜ 0.05或<0.01).不同程度的OSAHS患者血清PON1活性比较差异有统计学意义(P＜0.05或＜0.01),且血清PON1活性随OSAHS程度加重而下降.血清PON1活性与HDL水平呈正相关(r=0.658,P＜0.01),与AHI呈负相关(r=-0.637,P＜ 0.01).21例中、重度OSAHS患者经3个月nCPAP治疗后血清PON1活性为(110.88±11.03)kU/L,较治疗前的(102.25±10.02) kU/L明显升高,差异有统计学意义(P＜0.01).结论 PON1可能参与OSAHS并发心血管疾病的发生,nCPAP治疗可能有助于降低OSAHS患者并发心血管疾病的危险性.
目的 研究阻塞型睡眠呼吸暫停低通氣綜閤徵(OSAHS)患者血清對氧燐酶1(PON1)活性和血脂的關繫,及經鼻持續氣道正壓通氣(nCPAP)治療前後的變化,探討PONI在OSAHS併髮心血管疾病中的可能作用.方法 86例OSAHS患者根據睡眠呼吸暫停指數(AHI)分為3組:輕度組(5＜AHI≤20) 24例,中度組(20＜ AHI≤40) 25例,重度組(AHI＞40) 37例.檢測各組間血脂水平及PON1活性併與20例健康者(對照組)進行比較,相關參數進行相關性分析,其中21例中、重度OSAHS患者進行nCPAP治療3箇月後複查多導睡眠圖(PSG)、PON1活性和血脂.結果 輕度組、中度組、重度組血清PON1活性分彆為(143.56±29.47)、(121.50±25.76)、(103.11±24.54) kU/L,均低于對照組的( 164.35±33.89) kU/L,差異有統計學意義(P＜ 0.05或<0.01).不同程度的OSAHS患者血清PON1活性比較差異有統計學意義(P＜0.05或＜0.01),且血清PON1活性隨OSAHS程度加重而下降.血清PON1活性與HDL水平呈正相關(r=0.658,P＜0.01),與AHI呈負相關(r=-0.637,P＜ 0.01).21例中、重度OSAHS患者經3箇月nCPAP治療後血清PON1活性為(110.88±11.03)kU/L,較治療前的(102.25±10.02) kU/L明顯升高,差異有統計學意義(P＜0.01).結論 PON1可能參與OSAHS併髮心血管疾病的髮生,nCPAP治療可能有助于降低OSAHS患者併髮心血管疾病的危險性.
목적 연구조새형수면호흡잠정저통기종합정(OSAHS)환자혈청대양린매1(PON1)활성화혈지적관계,급경비지속기도정압통기(nCPAP)치료전후적변화,탐토PONI재OSAHS병발심혈관질병중적가능작용.방법 86례OSAHS환자근거수면호흡잠정지수(AHI)분위3조:경도조(5＜AHI≤20) 24례,중도조(20＜ AHI≤40) 25례,중도조(AHI＞40) 37례.검측각조간혈지수평급PON1활성병여20례건강자(대조조)진행비교,상관삼수진행상관성분석,기중21례중、중도OSAHS환자진행nCPAP치료3개월후복사다도수면도(PSG)、PON1활성화혈지.결과 경도조、중도조、중도조혈청PON1활성분별위(143.56±29.47)、(121.50±25.76)、(103.11±24.54) kU/L,균저우대조조적( 164.35±33.89) kU/L,차이유통계학의의(P＜ 0.05혹<0.01).불동정도적OSAHS환자혈청PON1활성비교차이유통계학의의(P＜0.05혹＜0.01),차혈청PON1활성수OSAHS정도가중이하강.혈청PON1활성여HDL수평정정상관(r=0.658,P＜0.01),여AHI정부상관(r=-0.637,P＜ 0.01).21례중、중도OSAHS환자경3개월nCPAP치료후혈청PON1활성위(110.88±11.03)kU/L,교치료전적(102.25±10.02) kU/L명현승고,차이유통계학의의(P＜0.01).결론 PON1가능삼여OSAHS병발심혈관질병적발생,nCPAP치료가능유조우강저OSAHS환자병발심혈관질병적위험성.
Objective To study the correlation between serum paraoxanase-1 (PON-1) activity and blood lipid and their changes before and after nasal continuous positive airway pressure ventilation (nCPAP) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and to investigate the effect of PON-1 on the occurrence of candiovascular diseases in OSAHS patients.Methods According to the apnea hypopnea index(AHI),86 OSAHS patients were divided into mild group(24 cases,5 ＜ AHI ≤20),moderate group (25 cases,20 <AHI≤40) and severe group (37 cases,AHI ＞40).Blood lipid levels and PON-1 activity were measured in all the subjects and compared with those in 20 healthy persons (control group),and the correlations with related indexes were analyzed.Results The serum PON-1 activity in mild group,moderate group and severe group were significantly lower than that in control group [ (143.56 ± 29.47),(121.50 ±25.76),(103.11±24.54) kU/L vs.(164.35±33.89) kU/L] (P＜0.05 or＜0.01).There was statistical significance in serum PON-1 activity among the three OSAHS groups (P ＜ 0.05 or ＜ 0.01 ).Serum PON-1 activity decreased with the severity of OSAHS.The serum PON-1 activity was positively correlated to HDL level (r =0.658,P ＜ 0.01 ) and negatively correlated to AHI (r ＝ -0.637,P ＜ 0.01 ).After 3-month nCPAP therapy,PON-1 activity in 21 patients with moderate and severe OSAHS was significantly higher than that before therapy [(110.88 ± 11.03) kU/L vs.( 102.25 ± 10.02) kU/L,P＜0.01 ].Conclusions PON-1 may contribute to the occurrence of cardiovascular diseases in OSAHS patients.nCPAP therapy may help to reduce the occurrence risk of cardiovascular diseases in OSAHS patients.
