Feng Huiping, Feng Huiqing, Zhang Congmin, Wu Kanjin, Yuan Yadong, Yang Hongshen, Guan Jitao, Wang Baofa
Department of Respiratory Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2002 Sep;25(9):531-4.
To investigate the changes of platelet activation, coagulability, and fibrinolytic activation in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) before and after the institution of nasal continuous positive airway pressure (nCPAP).
Fifty-eight cases of OSAHS confirmed by polysomnography (PSG) were selected as the trial group, 20 subjects without OSAHS were recruited as the control group. Eleven patients with severe OSAHS were treated by nCPAP. Plasma GMP-140, GPIIb/IIIa and D-dimer were measured by ELISA.
Plasma levels of GMP-140, GPIIb/IIIa and D-dimer were significantly higher in patients with moderate to severe OSAHS than those in the control group, P < 0.05, and nCPAP therapy decreased their levels significantly, P < 0.001. GMP-140, GPIIb/IIIa and D-dimer were correlated positively with AHI, and negatively with minimal oxygen saturation, P < 0.001.
Our findings suggest that activation of platelet and coagulation system with fibrinolytic activation may be associated with the high prevalence of cerebrovascular and cardiovascular events in patients with OSAHS. nCPAP therapy is effective in correcting these coagulatory and fibrinolytic abnormalities.
探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者在接受鼻持续气道正压通气（nCPAP）治疗前后血小板活化、凝血功能及纤溶活性的变化。
选取经多导睡眠图（PSG）确诊的58例OSAHS患者作为试验组，招募20例无OSAHS的受试者作为对照组。11例重度OSAHS患者接受nCPAP治疗。采用酶联免疫吸附测定法（ELISA）检测血浆GMP-140、GPIIb/IIIa和D-二聚体水平。
中重度OSAHS患者血浆GMP-140、GPIIb/IIIa和D-二聚体水平显著高于对照组，P<0.05，nCPAP治疗后其水平显著降低，P<0.001。GMP-140、GPIIb/IIIa和D-二聚体与呼吸暂停低通气指数（AHI）呈正相关，与最低血氧饱和度呈负相关，P<0.001。
我们的研究结果表明，血小板和凝血系统的激活以及纤溶活性可能与OSAHS患者脑血管和心血管事件的高发生率有关。nCPAP治疗可有效纠正这些凝血和纤溶异常。
