Friščić Tea, Perčić Marko, Vidović Domagoj, Štajduhar Andrija, Galić Edvard
Clinical Hospital Sveti Duh, 10000 Zagreb, Croatia.
University Psychiatric Hospital Vrapče, 10000 Zagreb, Croatia.
J Clin Med. 2022 Oct 17;11(20):6113. doi: 10.3390/jcm11206113.
Obstructive sleep apnea (OSA) is a common sleep disorder leading to increased risk of developing cardiovascular diseases (CVDs) by supporting a low-grade chronic inflammation as one of the pathological mechanisms. The continuous positive airway pressure (CPAP) device is used as an effective treatment for moderate and severe OSA. Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), white blood cell-mean platelet volume ratio (WMR), C-reactive protein-albumin ratio (CAR) and fibrinogen-albumin ratio (FAR) are new potential inflammatory biomarkers that are widely available and were shown to be possibly favorable screening or follow-up tools for moderate- or severe-grade OSA, as well as indirect indicators for cardiovascular risk. Our study evaluated the impact of CPAP therapy in patients with severe OSA and acceptable therapy adherence on NLR, PLR, WMR, FAR and CAR. Of 57 patients who were initially enrolled and had no exclusion criteria, 37 had a satisfactory CPAP adherence (usage of ≥4 h per night) after a minimum of 6 months of therapy. There was a statistically significant difference in NLR (2.122 ± 0.745 before therapy vs. 1.888 ± 0.735 after therapy) and FAR (86.445 ± 18.763 before therapy vs. 77.321 ± 19.133 after therapy) suggesting a positive effect of the CPAP therapy on chronic inflammatory states, thereby possibly reducing cardiovascular risk.
阻塞性睡眠呼吸暂停（OSA）是一种常见的睡眠障碍，通过支持低度慢性炎症作为病理机制之一，导致患心血管疾病（CVD）的风险增加。持续气道正压通气（CPAP）设备被用作治疗中度和重度OSA的有效方法。中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、白细胞与平均血小板体积比值（WMR）、C反应蛋白与白蛋白比值（CAR）以及纤维蛋白原与白蛋白比值（FAR）是新的潜在炎症生物标志物，它们广泛可用，并且已被证明可能是中度或重度OSA的良好筛查或随访工具，以及心血管风险的间接指标。我们的研究评估了CPAP治疗对重度OSA且治疗依从性良好的患者的NLR、PLR、WMR、FAR和CAR的影响。在最初纳入且无排除标准的57例患者中，37例在至少6个月的治疗后CPAP依从性良好（每晚使用≥4小时）。NLR（治疗前2.122±0.745 vs.治疗后1.888±0.735）和FAR（治疗前86.445±18.763 vs.治疗后77.321±19.133）存在统计学显著差异，表明CPAP治疗对慢性炎症状态有积极作用，从而可能降低心血管风险。
