Tazbirek Maciej, Slowinska Ludmila, Skoczynski Szymon, Pierzchala Wladyslaw
Department of Pneumonology, Medical University of Silesia, Katowice, Poland.
Clin Hemorheol Microcirc. 2009;41(4):241-9. doi: 10.3233/CH-2009-1175.
Our aim was to analyze rheological properties of blood and plasma in patients (n=31) with obstructive sleep apnea (OSA) before and after five nights of continuous positive airway pressure (CPAP) therapy as compared with a well-matched control group (n=19). Rheology measurements included blood viscosity, plasma viscosity, erythrocyte elongation and erythrocyte deformability variables specific to the aggregation process. The mean whole blood viscosity of the OSA groups was 18.6% higher than that of the control group (P<0.001), plasma viscosity was 7.2% higher (P<0.001), and the blood count was 6% higher (P<0.001). The corrected viscosity of the OSA group was elevated 6.6% (P<0.05) and the aggregation index was 9.3% higher (P<0.05) relative to the control group. Aggregation half-time of the OSA group was 23.5% shorter than that of the control group (P<0.05). Following CPAP therapy, the rheological variables of the OSA group were significantly reduced: whole blood viscosity was 10.5% lower (P<0.001), plasma viscosity was 4.1% lower (P<0.05), corrected blood viscosity was 4.8% lower (P<0.05), and the aggregation index was 7% lower (P<0.05), while the aggregation half-time was increased 25.4% (P<0.05). There were significant correlations between rheologic and polysomnographic variables for the OSA group. Therefore, five consecutive nights of CPAP therapy improved blood rheological properties in patients with OSA. These findings may help to determine cardiovascular prognoses in these patients.
我们的目的是分析阻塞性睡眠呼吸暂停(OSA)患者(n = 31)在持续气道正压通气(CPAP)治疗五晚前后的血液和血浆流变学特性,并与匹配良好的对照组(n = 19)进行比较。流变学测量包括血液粘度、血浆粘度、红细胞伸长率以及与聚集过程相关的红细胞变形性变量。OSA组的平均全血粘度比对照组高18.6%(P<0.001),血浆粘度高7.2%(P<0.001),血细胞计数高6%(P<0.001)。与对照组相比,OSA组的校正粘度升高了6.6%(P<0.05),聚集指数高9.3%(P<0.05)。OSA组的聚集半衰期比对照组短23.5%(P<0.05)。CPAP治疗后,OSA组的流变学变量显著降低:全血粘度降低10.5%(P<0.001),血浆粘度降低4.1%(P<0.05),校正血液粘度降低4.8%(P<0.05),聚集指数降低7%(P<0.05),而聚集半衰期增加25.4%(P<0.05)。OSA组的流变学和多导睡眠图变量之间存在显著相关性。因此,连续五晚的CPAP治疗改善了OSA患者的血液流变学特性。这些发现可能有助于确定这些患者的心血管预后。