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目的探讨阻塞性睡眠呼吸暂停低通气综合症(OSAHS)患者血脂代谢及颈动脉内膜斑块形成情况。方法选取经多导睡眠监测诊断为OSAHS的男性患者99例为OSAHS组,并按睡眠呼吸暂停低通气指数(AHI)分为轻中度组(10例)、重度组(34例)和极重度组(55例),同时选取健康查体人员48例为对照组,受试者均采取空腹血测定血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,所有OSAHS患者均行颈动脉彩超检查并比较不同程度OSAHS患者颈动脉内膜斑块发生率的差异性。结果结果与对照组相比,各OSAHS组BMI均升高,HDL-C均降低,差异均有统计学意义(P<0.05),重度和极重度OSAHS组TG较对照组均升高(P<0.05),TC及LDL-C的差异无统计学意义(P>0.05)。相关性分析提示:OSAHS患者的IM T与AHI呈正相关(r=0.32,P=0.001),与平均SpO_2呈负相关(r=-0.233,P=0.02),与最低SpO_2无明显相关(r=-0.168,P=0.096)。极重度OSAHS患者的斑块发生率分别高于轻中度患者和重度患者,差异均有统计学意义(P<0.05)。结论 OSAHS可能影响患者的血脂代谢及颈动脉内膜斑块的发生,极重度OSAHS患者颈动脉内膜斑块的发生率明显升高。
Objective To investigate the lipid metabolism and carotid intima plaque formation in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Ninety-nine male patients diagnosed as OSAHS by polysomnography were divided into two groups: OSAHS group (n = 10), severe group (n = 34) and extreme severe hypoxemia group (55 cases). 48 healthy volunteers were selected as the control group. Fasting blood samples were taken for determination of serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) , And low-density lipoprotein cholesterol (LDL-C). All patients with OSAHS underwent carotid ultrasonography and compared the incidence of carotid intima plaque in patients with OSAHS. Results Compared with the control group, the BMI and the HDL-C in OSAHS group were significantly lower than those in the control group (P <0.05), and those in the OSAHS group were significantly higher than those in the control group (P < 0.05). The differences of TC and LDL-C were not statistically significant (P> 0.05). Correlation analysis showed that there was a positive correlation between IMT and AHI in patients with OSAHS (r = 0.32, P = 0.001) and negatively correlated with mean SpO2 (r = -0.233, P = 0.02) -0.168, P = 0.096). The incidence of plaque in patients with very severe OSAHS was higher than those in patients with mild to moderate severity, respectively, with significant differences (P <0.05). Conclusion OSAHS may affect the blood lipid metabolism and carotid artery plaque in patients with severe OSAHS patients with carotid artery plaque was significantly increased.