Sun Xueting, Sun Zhidan, Feng Yanhong
Department of Ultrasound，the First Affiliated Hospital of Jinzhou Medical University，Jinzhou，121000，China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2021 Aug;35(8):707-711. doi: 10.13201/j.issn.2096-7993.2021.08.008.
To examine the changes of carotid artery elasticity in patients with obstructive sleep apnea（OSA） before and after continuous positive airway pressure（CPAP） treatment by ultrafast pulse wave velocity（UFPWV） technique，and to explore the influencing factors of carotid artery elasticity in OSA patients，and to provide guidance for clinical prevention and treatment of cardiovascular complications. Methods：Fifty cases of moderate and severe OSA patients diagnosed with PSG monitoring from January 2020 to December 2020 were collected as the OSA group，at the same time，40 healthy subjects who participated in physical examination and matched with OSA group in age and gender were selected as the control group.The OSA group was treated with CPAP for 12 weeks.Clinical indicators，carotid intima-media thickness（IMT），and pulse wave velocity at the beginning of systole（PWVBS） and pulse wave velocity at the end of systole（PWVES） were recorded in the control group，and the above data were collected in the OSA group before and after treatment.The changes of various indicators between the control group and the OSA group，and between the OSA group before and after treatment were compared.The correlative factors and influencing factors of PWVBS and PWVES are analyzed. Results：The serum lipid indexes，IMT，PWVBS and PWVES in OSA group were higher than those in control group（<0.05）.Comparison between post-treatment and pre-treatment with CPAP in OSA group：PWVBS，PWVES，apnea hypopnea index（AHI），blood oxygen saturation（SaO₂） less than 90% of the time，the percentage of monitoring time when SaO₂ was less than 90%（T90），low density lipoprotein cholesterol（LDL-C）and triglyceride（TG） were decreased（<0.05）.Lowest blood oxygen saturation（LSaO₂） and high density lipoprotein cholesterol（HDL-C） increased（<0.05）.Age，systolic blood pressure，IMT，AHI，T90 and time of oxygen saturation below 90% were positively correlated with PWVBS and PWVES，while HDL-C and LSaO₂ were negatively correlated with them（<0.05）.The risk factors of PWVBS and PWVES included systolic blood pressure，AHI，TC，T90.Conclusion：Moderate and severe OSA can reduce arterial elasticity.CPAP can improve carotid artery elasticity function in patients with OSA.UFPWV technique is more sensitive to quantitatively evaluate the changes of arterial elasticity in patients with OSA than traditional two-dimensional ultrasound.
采用超快速脉搏波速度（UFPWV）技术检测阻塞性睡眠呼吸暂停（OSA）患者持续气道正压通气（CPAP）治疗前后颈动脉弹性的变化，探讨OSA患者颈动脉弹性的影响因素，为临床防治心血管并发症提供指导。方法：收集2020年1月至2020年12月经PSG监测确诊的50例中重度OSA患者作为OSA组，同时选取40例年龄、性别与OSA组相匹配的参加体检的健康受试者作为对照组。OSA组接受CPAP治疗12周。记录对照组的临床指标、颈动脉内膜中层厚度（IMT）、收缩期开始时的脉搏波速度（PWVBS）和收缩期末尾时的脉搏波速度（PWVES），OSA组在治疗前后收集上述数据。比较对照组与OSA组之间以及OSA组治疗前后各项指标的变化。分析PWVBS和PWVES的相关因素及影响因素。结果：OSA组的血脂指标、IMT、PWVBS和PWVES均高于对照组（<0.05）。OSA组CPAP治疗后与治疗前比较：PWVBS、PWVES、呼吸暂停低通气指数（AHI）、血氧饱和度（SaO₂）低于90%的时间、SaO₂低于90%的监测时间百分比（T90）、低密度脂蛋白胆固醇（LDL-C）和甘油三酯（TG）均降低（<0.05）。最低血氧饱和度（LSaO₂）和高密度脂蛋白胆固醇（HDL-C）升高（<0.05）。年龄、收缩压、IMT、AHI、T90和血氧饱和度低于90%的时间与PWVBS和PWVES呈正相关，而HDL-C和LSaO₂与它们呈负相关（<0.05）。PWVBS和PWVES的危险因素包括收缩压、AHI、总胆固醇（TC）、T90。结论：中重度OSA可降低动脉弹性。CPAP可改善OSA患者的颈动脉弹性功能。UFPWV技术在定量评估OSA患者动脉弹性变化方面比传统二维超声更敏感。
