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持续气道正压通气治疗对冠心病合并阻塞性睡眠呼吸暂停患者动脉僵硬度和炎症因子的影响

Effects of continuous positive airway pressure treatment on arterial stiffness and inflammatory factors in patients with coronary heart disease complicated with obstructive sleep apnea.

作者信息

Wang Liang, Wang Yuanqi, Jiao Tiantian, Xu Linghao, Ji Endong, Tapu Sakibur Rahman, Liu Yehong, Li Jiming

机构信息

Department of Cardiology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.

School of Medicine, Tongji University, Shanghai, China.

出版信息

J Cardiothorac Surg. 2025 Jan 11;20(1):59. doi: 10.1186/s13019-024-03252-2.

Abstract

BACKGROUND

Continuous Positive Airway Pressure (CPAP) treatment brings more benefits than risks to most coronary heart disease (CHD) patients with obstructive sleep apnea (OSA). However, the pathophysiological mechanism by which CPAP treatment improves the prognosis of patients with CHD and OSA remains unclear. The purpose of this study was to clarify whether CPAP can improve arterial stiffness and inflammatory factor levels in CHD patients with OSA, and to further improve prognosis.

METHOD

59 patients with coronary heart disease complicated by moderate to severe sleep apnea were divided into a CPAP treatment group (CPAP + coronary heart disease standard treatment) and a control group (only coronary heart disease standard treatment). Peripheral blood test reports were collected and pulse wave velocity (PWV) measurements were performed for each patient at the beginning, 3 months, and 6 months of treatment.

RESULTS

After 6 months of treatment, the CPAP group showed more significant improvement in the levels of inflammatory factors such as white blood cell (WBC), neutrophil (N), C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT), and PWV than the control group.

CONCLUSION

After active treatment with CPAP, arterial stiffness and inflammatory cytokine levels in patients with coronary heart disease and OSA improved. This association should be given more attention in clinical practice, and sleep apnea should be actively treated.

摘要

背景

持续气道正压通气(CPAP)治疗对大多数患有阻塞性睡眠呼吸暂停(OSA)的冠心病(CHD)患者带来的益处多于风险。然而,CPAP治疗改善CHD和OSA患者预后的病理生理机制仍不清楚。本研究的目的是阐明CPAP是否能改善合并OSA的CHD患者的动脉僵硬度和炎症因子水平,并进一步改善预后。

方法

将59例冠心病合并中度至重度睡眠呼吸暂停的患者分为CPAP治疗组(CPAP + 冠心病标准治疗)和对照组(仅冠心病标准治疗)。在治疗开始时、治疗3个月和6个月时收集每位患者的外周血检测报告并进行脉搏波速度(PWV)测量。

结果

治疗6个月后,CPAP组白细胞(WBC)、中性粒细胞(N)、C反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)等炎症因子水平及PWV的改善程度均比对照组更显著。

结论

CPAP积极治疗后,冠心病合并OSA患者的动脉僵硬度和炎症细胞因子水平得到改善。这种关联在临床实践中应得到更多关注,应积极治疗睡眠呼吸暂停。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49c1/11724610/c52d36682398/13019_2024_3252_Fig1_HTML.jpg

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