Msaad Sameh, Chaabouni Akram, Marrakchi Rim, Boudaya Mariem, Kotti Amina, Feki Walid, Jamoussi Kamel, Kammoun Samy
Department of Respiratory and Sleep Medicine, Hédi Chaker University Hospital of Sfax, Tunisia.
University of Sfax, Faculty of Medicine of Sfax, Tunisia.
Sleep Disord. 2020 Nov 1;2020:8913247. doi: 10.1155/2020/8913247. eCollection 2020.
Systemic and airway inflammation has recently been linked to obstructive sleep apnea-hypopnea syndrome (OSAHS) and is considered to be a probable risk factor for OSAHS-induced cardiovascular damage. High-sensitivity C-reactive protein (hs-CRP), as an inflammatory mediator, may be useful for the prediction of the risk of cardiovascular disease (CVD) and assessment of nocturnal continuous positive airway pressure (nCPAP) therapy effect in OSAHS patients.
A prospective, controlled, cross-sectional study was conducted on 64 consecutive adult subjects with suspected sleep-disordered breathing (SDB).
OSAHS was confirmed in 43 patients (24 normotensive and 19 hypertensive patients) and ruled out in 21 normotensive subjects (controls). The median plasma level of hs-CRP did not differ significantly between OSAHS patients and controls. It showed an unmarked rise with the severity of OSAHS ( = 0.20) and was not correlated with AHI ( = 0.067; = 0.28). After adjusting for cervical perimeter (CP), waist-to-hip ratio (WHR), and blood sugar level, hs-CRP level of 1 mg/dL or greater was significantly more often observed in OSAHS patients compared with controls ( = 0.032; OR = 5.60) and was also significantly associated with AHI ( = 0.021). A significant decrease in the median plasma hs-CRP level was observed in CPAP compliant patients ( = 0.006). Of those, only normotensive patients showed a significant decrease in plasma hs-CRP level. In hypertensive ones, however, the hs-CRP level dropped but not significantly. Using a linear regression model, the change in hs-CRP level (hs-CRP) following a 6-month-nCPAP therapy was found to positively correlate with the baseline hs-CRP level for both hypertensive ( = 0.02; = 0.68), and even more normotensive OSAHS patients ( < 0.0001; = 0.89).
nCPAP therapy may have a cardiovascular protective effect in OSAHS patients. hs-CRP level would be useful as a valuable predictor of success in OSAHS treatment monitoring.
全身及气道炎症最近被认为与阻塞性睡眠呼吸暂停低通气综合征（OSAHS）有关，并且被视为OSAHS所致心血管损害的一个可能危险因素。高敏C反应蛋白（hs-CRP）作为一种炎症介质，可能有助于预测心血管疾病（CVD）风险以及评估OSAHS患者夜间持续气道正压通气（nCPAP）治疗效果。
对64例连续的疑似睡眠呼吸障碍（SDB）成年受试者进行了一项前瞻性、对照、横断面研究。
43例患者（24例血压正常者和19例高血压患者）确诊为OSAHS，21例血压正常受试者（对照组）排除OSAHS。OSAHS患者与对照组的hs-CRP血浆中位数水平无显著差异。其随OSAHS严重程度呈不明显升高（r = 0.20），且与呼吸暂停低通气指数（AHI）无相关性（r = 0.067；P = 0.28）。在校正颈围（CP）、腰臀比（WHR）和血糖水平后，与对照组相比，OSAHS患者中hs-CRP水平≥1mg/dL更为常见（P = 0.032；OR = 5.60），且也与AHI显著相关（P = 0.021）。在依从CPAP治疗的患者中观察到血浆hs-CRP中位数水平显著下降（P = 0.006）。其中，只有血压正常患者的血浆hs-CRP水平显著下降。然而，高血压患者的hs-CRP水平虽有下降但不显著。使用线性回归模型发现，6个月nCPAP治疗后hs-CRP水平变化（Δhs-CRP）与高血压OSAHS患者（P = 0.02；r = 0.68）以及血压正常的OSAHS患者（P < 0.0001；r = 0.89）的基线hs-CRP水平呈正相关。
nCPAP治疗可能对OSAHS患者具有心血管保护作用。hs-CRP水平可作为OSAHS治疗监测成功与否的有价值预测指标。
