Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
Sleep Breath. 2011 Jan;15(1):71-6. doi: 10.1007/s11325-009-0323-x. Epub 2010 Jan 19.
We investigated whether the nasal continuous positive airway pressure (nCPAP) could have impacts on impaired vascular functions and serum cardiovascular risk factors in obstructive sleep apnea syndrome (OSAS).
We enrolled 25 OSAS patients of moderate to severe degree. After polysomnography, carotid-femoral pulse wave velocity (cfPWV) and flow-mediated dilation (FMD) were measured. Also, serum levels of C-reactive protein (CRP), total cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, glucose, and insulin were measured. After nCPAP treatment (mean duration, 138.7 ± 42.6 days), these tests were performed again.
The mean apnea hypopnea index prior to nCPAP was 64.9 ± 20.0/h, which decreased to 4.1 ± 2.0/h with nCPAP (p < 0.001). After nCPAP, cfPWV (m/s) decreased from 11.2 ± 4.5 to 9.3 ± 2.1 (p = 0.031), and FMD (%) was improved from 5.52 ± 2.49 to 6.58 ± 2.50 (p = 0.006). Body mass index, serum levels of CRP, total cholesterol, triglyceride, HDL cholesterol, or glucose did not change after nCPAP. Insulin resistance was not improved either.
The cfPWV and FMD were significantly improved after nCPAP treatment, even though there was no significant change in body weight or serum cardiovascular risk factors. The nCPAP treatment could decrease risks of cardiovascular complications in OSAS patients through improving vascular functions.
我们研究经鼻持续气道正压通气(nCPAP)是否会对阻塞性睡眠呼吸暂停综合征(OSAS)患者血管功能受损和血清心血管危险因素产生影响。
我们纳入了 25 例中重度 OSAS 患者。行多导睡眠图检查后,测量颈-股脉搏波速度(cfPWV)和血流介导的舒张功能(FMD)。同时,检测血清 C 反应蛋白(CRP)、总胆固醇、甘油三酯、高密度脂蛋白胆固醇(HDL-C)、血糖和胰岛素水平。nCPAP 治疗(平均持续时间为 138.7±42.6 天)后,再次进行上述检查。
nCPAP 治疗前平均呼吸暂停低通气指数为 64.9±20.0/小时,治疗后降至 4.1±2.0/小时(p<0.001)。nCPAP 治疗后,cfPWV(m/s)由 11.2±4.5 降至 9.3±2.1(p=0.031),FMD(%)由 5.52±2.49 升至 6.58±2.50(p=0.006)。nCPAP 治疗后体重指数、血清 CRP、总胆固醇、甘油三酯、HDL-C 或血糖水平无变化,胰岛素抵抗也无改善。
nCPAP 治疗后 cfPWV 和 FMD 显著改善,尽管体重或血清心血管危险因素无显著变化。nCPAP 治疗可能通过改善血管功能降低 OSAS 患者心血管并发症风险。