持續氣道正壓通氣對合并OSAHS 的冠心病患者血清炎癥因子水平的影響_《中國呼吸與危重監護雜志》

作者：

 胡克 ¹ , 姜燕 ² , 范慧君 ² , 何靜雅 ¹

1 武漢大學人民醫院呼吸科（湖北武漢 430060）;;
2 武漢市第五人民醫院呼吸科（湖北武漢 430052）;

關鍵詞：

冠心病阻塞性睡眠呼吸暫停低通氣綜合征炎癥因子持續氣道正壓

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目的探討合并存在OSAHS 的冠心病患者外周血TNF-α、IL-6 和高敏C-反應蛋白( hs-CRP) 的水平, 以及持續氣道正壓通氣( CPAP) 治療后其水平的變化。方法選擇2007 年10 月至2008 年10 月間在武漢大學人民醫院心血管內科住院的冠心病患者76 例, 23 例體檢正常者作為正常對照。對冠心病患者進行多導睡眠監測( PSG) , 并檢測76 例冠心病患者及23 例對照組外周血TNF-α、IL-6、hs-CRP 水平。對中重度( AHI≥15 次/h) OSAHS 冠心病患者使用Auto-CPAP 治療3 個月, 治療結束后, 再次檢測上述指標。結果 76 例冠心病患者中, 41 例( 53. 9% ) 合并中重度OSAHS( AHI≥15 次/h) , 該組患者接受Auto-CPAP 治療。冠心病組TNF-α、IL-6、hs-CRP 水平明顯高于對照組( P 均 lt;0. 01) ; 中重度OSAHS 冠心病患者TNF-α、IL-6、hs-CRP 的表達均顯著高于不合并OSAHS的冠心病患者, 而在Auto-CPAP治療后明顯下降。結論冠心病患者存在明顯的前炎癥狀態, OSAHS可能加劇冠心病的炎性損傷。對于存在中重度OSAHS 的冠心病患者采用CPAP 治療可降低血清炎癥因子水平。

引用本文： 胡克,姜燕,范慧君,何靜雅. 持續氣道正壓通氣對合并OSAHS 的冠心病患者血清炎癥因子水平的影響. 中國呼吸與危重監護雜志, 2009, 09(4): 376-379. doi: 復制

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5.	Kokturk O, Ciftci TU, Mollarecep E, et al. Elevated C-reactive protein levels and increased cardiovascular risk in patients with obstructive sleep apnea syndrome. Int Heart J, 2005, 46: 801-809.
6.	胡克, 李清泉, 楊炯, 等. 茶堿對穩定期慢性充血性心力衰竭患者睡眠呼吸障礙的作用. 中國呼吸與危重監護雜志, 2004, 3: 372-375.
7.	The Report of an American Academy of Sleep Medicine Task Force.Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in linical research.Sleep, 1999, 22: 667-689.
8.	Kosmala W, Derzhko R, Przewlocka-Kosmala M, et al. Plasma levels of TNF-alpha, IL-6 , and IL-10 and their relationship with left ventricular diastolic function in patients with stable angina pectoris and preserved left ventricular systolic performance. Coron Artery Dis,2008, 19: 375-382.
9.	Kohler M, Ayers L, Pepperell JC, et al. Effects of continuous positive airway pressure on systemic inflammation in patients with moderate to severe obstructive sleep apnoea: a randomised controlled trial.Thorax, 2009, 64: 67-73.

1. Wilson PW. Evidence of systemic inflammation and estimation of coronary artery disease risk: a population perspective. Am J Med,2008, 121( 10 Suppl 1) : S15-S20.
2. Zamarron C, García Paz V, Riveiro A. Obstructive sleep apnea syndrome is a systemic disease. Current evidence. Eur J Intern Med,2008, 19: 390-398.
3. Selmi C, Montano N, Furlan R, et al. Inflammation and oxidative stress in obstructive sleep apnea syndrome. Exp Biol Med, 2007, 232 :1409-1413.
4. Somers VK,White DP, Amin R, et al. Sleep apnea and cardiovascular disease: an American Heart Association/ American College of Cardiology Foundation Scientific Statement from the merican Heart Association Council for High Blood Pressure Research Professional Education Committee, Council on Clinical Cardiology, Stroke Council, and Council on Cardiovascular Nursing. In collaboration with the National Heart, Lung, and Blood Institute National Center on Sleep Disorders Research ( National Institutes of Health ) .Circulation, 2008, 118: 1080-1111.
5. Kokturk O, Ciftci TU, Mollarecep E, et al. Elevated C-reactive protein levels and increased cardiovascular risk in patients with obstructive sleep apnea syndrome. Int Heart J, 2005, 46: 801-809.
6. 胡克, 李清泉, 楊炯, 等. 茶堿對穩定期慢性充血性心力衰竭患者睡眠呼吸障礙的作用. 中國呼吸與危重監護雜志, 2004, 3: 372-375.
7. The Report of an American Academy of Sleep Medicine Task Force.Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in linical research.Sleep, 1999, 22: 667-689.
8. Kosmala W, Derzhko R, Przewlocka-Kosmala M, et al. Plasma levels of TNF-alpha, IL-6 , and IL-10 and their relationship with left ventricular diastolic function in patients with stable angina pectoris and preserved left ventricular systolic performance. Coron Artery Dis,2008, 19: 375-382.
9. Kohler M, Ayers L, Pepperell JC, et al. Effects of continuous positive airway pressure on systemic inflammation in patients with moderate to severe obstructive sleep apnoea: a randomised controlled trial.Thorax, 2009, 64: 67-73.

《中國呼吸與危重監護雜志》

持續氣道正壓通氣對合并OSAHS 的冠心病患者血清炎癥因子水平的影響

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《中國呼吸與危重監護雜志》

持續氣道正壓通氣對合并OSAHS 的冠心病患者血清炎癥因子水平的影響

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