Zhang Xilong, Yin Kaisheng, Wang Hong, Su Mei, Yang Yu
Department of Respiratory Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Chin Med J (Engl). 2003 Sep;116(9):1426-8.
To characterize the prethrombotic state (PTS) in elderly Chinese patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and the effect of nasal continuous positive airway pressure (nCPAP) ventilation on their PTS.
Forty-one elderly patients with moderate and severe OSAHS were enrolled into the OSAHS group and underwent nCPAP treatment. Their blood samples were drawn at 6:00 am and 4:00 pm before and during nCPAP treatment, respectively, to test hemocrit, platelet aggregation (PAG), whole blood viscosity (WBV), plasma fibrinogen (fng), prothrombin time (PT) and activated partial thromboplastin time (APTT). All blood factors were also tested in a control group consisting of 32 healthy elderly Chinese with neither OSAHS nor cerebrocardiac vascular disease.
In the OSAHS group there was a significantly higher hemocrit, WBV, fng, and a significantly shorter PT and APTT at 6:00 am compared to 4:00 pm before nCPAP treatment, while there was no significant difference among all blood test factors between 6:00 am and 4:00 pm on day 30 of the nCPAP treatment. In the OSAHS group, the hemocrit, WBV, PAG and plasma fng were significantly lower and the PT and APTT were significantly longer at 6:00 am on day 30 of the nCPAP treatment compared to 6:00 am before the nCPAP treatment. A significantly lower hemocrit, but a much longer PT and APTT were observed at 4:00 pm on day 30 of the treatment, compared with 4:00 pm before the treatment. No significant difference among the blood test factors was found between 6:00 am and 4:00 pm blood in the control group or between the control and OSAHS groups after 30 days of nCPAP treatment.
In elderly Chinese OSAHS patients, PTS could be effectively eliminated by nCPAP treatment.
探讨老年中国阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的血栓前状态（PTS）特点以及经鼻持续气道正压通气（nCPAP）对其PTS的影响。
41例中重度OSAHS老年患者纳入OSAHS组并接受nCPAP治疗。分别于nCPAP治疗前及治疗期间的上午6:00和下午4:00采集其血样，检测血细胞比容、血小板聚集率（PAG）、全血黏度（WBV）、血浆纤维蛋白原（fng）、凝血酶原时间（PT）和活化部分凝血活酶时间（APTT）。在由32名既无OSAHS也无心脑血管疾病的健康中国老年受试者组成的对照组中也对所有血液指标进行了检测。
在OSAHS组中，与nCPAP治疗前下午4:00相比，上午6:00时血细胞比容、WBV、fng显著更高，PT和APTT显著更短；而在nCPAP治疗第30天上午6:00和下午4:00时所有血液检测指标之间无显著差异。在OSAHS组中，与nCPAP治疗前上午6:00相比，nCPAP治疗第30天上午6:00时血细胞比容、WBV、PAG和血浆fng显著更低，PT和APTT显著更长。与治疗前下午4:00相比，治疗第30天下午4:00时血细胞比容显著更低，但PT和APTT显著更长。在对照组中上午6:00和下午4:00时血液检测指标之间以及nCPAP治疗30天后对照组与OSAHS组之间均未发现血液检测指标有显著差异。
在老年中国OSAHS患者中，nCPAP治疗可有效消除PTS。
