University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania; Clinical Emergency Hospital "Sf. Ioan", Bucharest, Romania.
University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania; Clinical Emergency Hospital of Bucharest, Romania.
Med Hypotheses. 2018 Jun;115:81-86. doi: 10.1016/j.mehy.2018.04.003. Epub 2018 Apr 10.
Obstructive sleep apnea syndrome (OSAS) is defined by recurrent episodes of significant reduction or absence of the oro-nasal airflow during sleep, in the presence of thorax and abdominal movements and snoring. The pathophysiological consequences of intermittent hypoxia determined by OSAS are represented by systemic inflammation, the release of free oxygen radicals and activation of the sympathetic nervous system. Cardiac arrhythmias are a frequent comorbidity in patients with OSAS.
We hypothesized that the continuous positive airway pressure (CPAP) therapy has an effect on inflammatory markers (erythrocyte sedimentation rate, fibrinogen, and red cell distribution width) in patients with OSAS and cardiac arrhythmias.
We tested this hypothesis on 52 patients diagnosed with OSAS and cardiac arrhythmias, divided into two groups: group A (patients who received CPAP therapy and pharmacological therapy) and group B (only pharmacological therapy). The patients were evaluated at enrollment (T0), at 3 and 6 months. We did not find a statistically significant difference of erythrocyte sedimentation rate (ESR) and fibrinogen levels between the two groups. Regarding the red cell distribution width (RDW), the CPAP treatment seems to have improved the RDW values in patients who received this treatment. Also, in patients from group A, a significant decrease in the average heart rate was noticed after 3 months.
Fibrinogen and ESR cannot be used for monitoring the CPAP therapy in patients with OSAS and arrhythmias. Instead, the beneficial effect of CPAP in patients with OSAS and cardiac arrhythmias can be monitored with the help of the RDW, which could also be used for evaluating the cardiovascular risk in patients with OSAS and arrhythmias.
阻塞性睡眠呼吸暂停综合征（OSAS）定义为睡眠期间反复出现显著的口鼻腔气流减少或停止，同时伴有胸腹部运动和打鼾。OSAS 引起的间歇性低氧血症的病理生理后果表现为全身炎症、游离氧自由基释放和交感神经系统激活。心律失常是 OSAS 患者的常见合并症。
我们假设持续气道正压通气（CPAP）治疗对 OSAS 伴心律失常患者的炎症标志物（红细胞沉降率、纤维蛋白原和红细胞分布宽度）有影响。
我们对 52 例确诊为 OSAS 伴心律失常的患者进行了分组研究，分为 A 组（接受 CPAP 治疗和药物治疗的患者）和 B 组（仅接受药物治疗的患者）。在入组时（T0）、第 3 个月和第 6 个月对患者进行评估。我们未发现两组间红细胞沉降率（ESR）和纤维蛋白原水平存在统计学差异。对于红细胞分布宽度（RDW），CPAP 治疗似乎改善了接受该治疗的患者的 RDW 值。此外，在 A 组患者中，治疗 3 个月后平均心率显著下降。
纤维蛋白原和 ESR 不能用于监测 OSAS 伴心律失常患者的 CPAP 治疗。相反，RDW 可用于监测 CPAP 治疗对 OSAS 伴心律失常患者的有益作用，也可用于评估 OSAS 伴心律失常患者的心血管风险。
