经 CPAP 治疗后仍存在睡眠惯性患者的内皮功能。
Endothelial function in patients with post-CPAP residual sleepiness.
机构信息
The Veterans Affairs Western New York Healthcare System, Buffalo, NY 14215-1199, USA.
出版信息
J Clin Sleep Med. 2010 Jun 15;6(3):251-5.
STUDY OBJECTIVES
The significance of residual excessive daytime sleepiness (EDS) on cardiovascular markers in patients with adequately treated obstructive sleep apnea (OSA) remains unclear. The objective of this study was to investigate flow-mediated dilatation (FMD) and inflammatory markers (C-reactive protein [CRP], tumor necrosis factor [TNF]-alpha, and interleukin [IL]-6) in continuous positive airway pressure (CPAP)-compliant patients with residual EDS compared with CPAP-compliant patients without residual EDS.
METHODS
FMD of the brachial artery was measured by ultrasound in 12 CPAP-compliant patients with OSA who had residual EDS and 12 age-, sex-, and body mass index-matched CPAP-compliant patients with OSA who did not have residual EDS on week 8 after initiation of CPAP. Twelve otherwise-healthy subjects without sleep disordered breathing were used as control subjects. Serum concentrations of CRP, TNF-alpha, and IL-6 were quantified by enzyme-linked immunosorbent assays.
RESULTS
Baseline FMD was comparable among CPAP-compliant patients with residual EDS (7.2 +/- 2.3), CPAP-compliant patients without residual EDS (8.6 +/- 2.1), and control subjects (7.7 +/- 1.4) (p = 0.37). The concentrations of CRP, TNF-alpha, and IL-6 were also not significantly different between subjects with CPAP-compliant residual EDS and those without residual EDS (p = 0.44, p = 0.37, and p = 0.42; respectively).
CONCLUSIONS
Residual EDS in patients with adequately treated OSA may not represent a risk factor for cardiovascular diseases.
研究目的
在接受充分治疗的阻塞性睡眠呼吸暂停（OSA）患者中，残余日间嗜睡（EDS）对心血管标志物的意义仍不清楚。本研究旨在探讨持续气道正压通气（CPAP）治疗后残余 EDS 的 OSA 患者与无残余 EDS 的 CPAP 治疗患者的肱动脉血流介导扩张（FMD）和炎症标志物（C 反应蛋白[CRP]、肿瘤坏死因子-α[TNF-α]和白细胞介素-6[IL-6]）。
方法
通过超声测量 12 例 CPAP 治疗依从性好的 OSA 患者（其中 8 周后仍有 EDS 残留）和 12 例年龄、性别和体重指数匹配的 OSA 患者（CPAP 治疗后无 EDS 残留）的肱动脉 FMD。12 例无睡眠呼吸障碍的健康受试者作为对照组。通过酶联免疫吸附试验定量测定 CRP、TNF-α和 IL-6 的血清浓度。
结果
CPAP 治疗后仍有 EDS 的患者（7.2±2.3）、无 EDS 的患者（8.6±2.1）和对照组（7.7±1.4）的基线 FMD 无显著差异（p=0.37）。CPAP 治疗后仍有 EDS 的患者和无 EDS 的患者的 CRP、TNF-α和 IL-6 浓度也无显著差异（p=0.44、p=0.37 和 p=0.42）。
结论
接受充分治疗的 OSA 患者的残余 EDS 可能不是心血管疾病的危险因素。
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